D-二聚体联合PCIS评分系统早期识别重症肺炎支原体肺炎的相关研究  

Study on Early Recognition of Severe Mycoplasma Pneumoniae Pneumonia by D-dimer Combined with PCIS Scoring System

作　　者：禚永淼 程唯嘉 孔杰华 ZHUO Yongmiao;CHENG Weijia;KONG Jiehua(Xingtan Hospital Affiliated to Shunde Hospital of Southern Medical University,Foshan 528325,China;不详)

机构地区：[1]南方医科大学顺德医院附属杏坛医院,广东佛山528325

出　　处：《中国医学创新》2023年第6期49-53,共5页Medical Innovation of China

基　　金：佛山市卫生健康局医学科研项目(20200016)。

摘　　要：目的:分析D-二聚体(D-D)联合小儿危重病例评分法(PCIS)早期识别重症肺炎支原体肺炎(MPP)的价值。方法:回顾性分析2019年3月-2021年9月由南方医科大学顺德医院附属杏坛医院儿科收治的200例MPP患儿临床资料,根据病情程度分为普通组(149例)、重症组(51例)。对比两组一般资料、生化指标[D-D、白细胞计数(WBC)、降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、乳酸脱氢酶(LDH)、谷草转氨酶(AST)、谷丙转氨酶(ALT)]、PCIS评分,经Pearson相关性分析重症MPP患儿D-D水平、PCIS评分与生化指标的相关性,绘制受试者工作特征(ROC)曲线,评估D-D水平、PCIS评分及二者联合预测重症MPP发生的价值。结果:重症组D-D、PCT、hs-CRP、AST、ALT、LDH水平均比普通组高,PCIS评分比普通组低(P<0.05);Pearson相关性显示,重症MPP患儿PCT、hs-CRP、AST、ALT、LDH水平与D-D水平均呈正相关(r=0.410,0.466,0.289,0.270,0.209,P<0.001),与PCIS评分均呈负相关(r=-0.643,-0.689,-0.424,-0.431,-0.132,P<0.001);ROC曲线结果显示,D-D水平、PCIS评分及二者联合预测重症MPP发生的AUC分别为0.865[95%CI(0.745,0.985)]、0.810[95%CI(0.635,0.985)]、0.972[95%CI(0.923,1.000)]。结论:D-D水平、PCIS评分与炎症反应、肝功能指标密切相关,二者联合可有效早期识别MPP的发生。Objective:To analyze the value of D-dimer(D-D)combined with pediatric critical illness score(PCIS)in early recognition of severe mycoplasma pneumoniae pneumonia(MPP).Method:The clinical data of 200 children with MPP admitted by the Department of Pediatrics,Xingtan Hospital Affiliated to Shunde Hospital of Southern Medical University from March 2019 to September 2021 were retrospectively analyzed.According to the degree of illness,they were divided into the normal group(149 cases)and severe group(51 cases).The general information,biochemical indicators[D-D,white blood cell count(WBC),procalcitonin(PCT),high-sensitivity C reactive protein(hs-CRP),lactate dehydrogenase(LDH),aspartate aminotransferase(AST),alanine aminotransferase(ALT)]and PCIS scores were compared between the two groups.The correlation between D-D level of children with severe MPP and PCIS scores and biochemical indicators was analyzed by Pearson correlation,and the working characteristics(ROC)curve of subjects was drawn to evaluate the D-D level,PCIS score and the value of the combination of the two in predicting the occurrence of severe MPP.Result:The levels of D-D,PCT,hs-CRP,AST,ALT and LDH in the severe group were higher than those in the normal group(P<0.05).The PCIS score was lower than that in the normal group(P<0.05).Pearson correlation showed that levels of PCT,hs-CRP,AST,ALT and LDH in children with severe MPP were positively correlated with D-D level(r=0.410,0.466,0.289,0.270,0.209,P<0.001),and negatively correlated with PCIS scores(r=-0.643,-0.689,-0.424,-0.431,-0.132,P<0.001).The ROC curve results showed AUC values for the D-D level,the PCIS score and the combination of the two to predict severe MPP were 0.865[95%CI(0.745,0.985)],0.810[95%CI(0.635,0.985)]and 0.972[95%CI(0.923,1.000)],respectively.Conclusion:D-D level and PCIS scores are closely related to inflammation and liver function indicators.The combination of the two can effectively identify the occurrence of MPP in the early stage.

关 键 词：重症肺炎支原体肺炎 D-二聚体 小儿危重病例评分法 

分 类 号：R725.6[医药卫生—儿科]