急性期血清生化指标在小儿难治性肺炎支原体肺炎中的早期诊断价值分析  

Study on the significance of sero-biochemical indices in early diagnosis of refractory mycoplasma pneumoniae pneumonia in pediatric patients

作　　者：王翠玲[1] 张忠浩[1] 姜丽娜[1] WANG Cui - ling;ZHANG Zhong - hao;JIANG Li - na.(Department of Pediatrics, Beijing Friendship Hospital, Capital Medical Univer- sity , Beijing 100050, China.)

机构地区：[1]首都医科大学附属北京友谊医院儿科,北京100050

出　　处：《临床和实验医学杂志》2018年第11期1221-1224,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的观察急性期血清生化指标在小儿难治性肺炎支原体肺炎中的早期诊断价值。方法回顾性收集2017年10~12月首都医科大学附属北京友谊医院收治的65例肺炎支原体肺炎患儿的临床资料,按2013年修订版中国儿童社区获得性肺炎管理指南诊断标准分为普通组和难治组,分析难治性肺炎支原体肺炎急性期血清生化指标(乳酸脱氢酶、丙氨酸/天冬氨酸转氨酶、C反应蛋白),绘制受试者工作曲线(ROC曲线),以得出部分指标的推荐诊断界值。结果难治组患儿平均年龄、住院/抗生素使用天数及激素使用概率均高于普通组,难治组在血清乳酸脱氢酶、丙氨酸转氨酶方面(350.9±107.1 IU/L,24.0±19.2 IU/L)显著高于普通组(305.6±68.7 IU/L,14.2±7.4 IU/L),而天冬氨酸转氨酶及C反应蛋白有增高趋势。结论乳酸脱氢酶和丙氨酸转氨酶在难治性肺炎支原体肺炎中具有鉴别诊断价值,对临床实际工作有一定的参考价值。Objective To explore the early-diagnostic significance of sero-biochemical indices in pediatric patients with refractory mycoplasma pneumoniae pneumonia（ RMPP）. Methods The clinical data including laboratory data as serum levels of lactate dehydrogenase（ LDH）,alanine aminotransferase（ ALT）,aspartate aminotransferase（ AST）,C-reactive protein（ CRP） in 65 pediatric patients with normal or refractory mycoplasma pneumonia were retrospectively collected and compared. ROC curve of some indices had been drawn in order to get the recommended cut-off value. Results Clinical data showed that the duration for hospital stay,cource for using antibiotics and corticosteroid in patients of refractory group were higher than those of normal group. Serological data indicated that the levels of LDH and ALT were significantly higher in refractory group（ 350. 9 ± 107. 1 IU/L and 24. 0 ± 19. 2 IU/L） and（ 305. 6 ± 68. 7 IU/L,14. 2 ± 7. 4 IU/L） in normal group,while serum levels of AST and CRP showed increased tendency in refractory group. Conclusion Serum levels of LDH and ALT have significant value in differential diagnosis,and they can be used as good reference in clinical practice.

关 键 词：小儿 肺炎支原体肺炎 难治性 生化指标 鉴别诊断 

分 类 号：R725.6[医药卫生—儿科]