Study On The Predictive Value Of Laboratory Indexes For Children With Severe Mycoplasma Pneumoniae Pneumonia

Objective:The aim of this study was to compare the differences of laboratory indexes between severe mycoplasma pneumoniae pneumonia(SMPP)and non-severe mycoplasma pneumoniae pneumonia(MPP)in children in order to explore the predictive value of common laboratory indexes of SMPP and to provide a basis for the clinical diagnostic criteria of SMPP.Method:From children who were admitted to the Pediatrics Department of the Second Hospital of Jilin University and diagnosed as MPP or severe pneumonia from November 1 of 2018 to October 31 of 2019,48 children with MPP and 43 children with SMPP who met the diagnostic criteria were selected.Retrospectively analyze the general data(gender,age)and other clinical indexes of each group,mainly laboratory indexes,including:heat peak,erythrocyte sedimentation(ESR),C-reactive protein(CRP),calcitonin Procalcitonin(PCT),white blood cell(WBC),platelet count(PLT),haemoglobin(HGB),high-sensitivity c-reactive protein(hsCRP),gluten Alanine transaminase(ALT),aspartate transaminase(AST),prealbumin(PA),lactate dehydrogenase(LDH),alpha-hydroxybutyrate dehydrogenase(HBDH),D-dimer(D-D),fibrinogen degradation product(FDP),fibrinogen(FIB).SPSS26.0 statistical software was used for analysis,after preprocessing the data,normality test and variance homogeneity test were performed on each measurement data,and the mean±standard deviation was used for comparison of measurement data which met normality and variance homogeneity test,these data were performed t test;other measurement data were expressed by median±quartile and was tested by Wilcoxon rank sum test;frequency number(frequency)was used for count data,andc~2 test was used for comparison.The variables with significant differences were screened through various comparisons(p<0.05).Through logistic regression analysis,predictive indexes of SMPP were obtained,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficiency of SMPP.Result:According to statistics,among the 18 variables included in the study,the count data suggested that the sex ratio was not significantly different between the SMPP group and the MPP group.In the measurement data,there were the statistically significant differences between the two groups,including age,heat peak,ESR,CRP,PCT,WBC,hsCRP,LDH,HBDH,D-D,FDB,FIB,these indicators are higher in the SMPP group than in the MPP group,PA was the only index which was significantly lower in the severe group than in the mild group;the variables with significant differences were screened through Comparison of Differentiation.Three different indexes were selected by binary logistic regression from variables which had significant difference:hsCRP,WBC,and D-D.The predictive indexes were evaluated by the ROC curve.The cutoff values of the three variables were 5.000mg/L,9.165*10~9/L,1.0746 ug/ml,and the area under curve(AUC)were 0.864,0.678,0.811,the sensitivity are 0.977,0.465 and 0.721,and the specificity were 0.646,0.917,0.813,respectively.The AUC value of the combining predictors could reach above 0.9.conclusion:hsCRP,WBC,D-D could be used as predictors of SMPP;hsCRP and D-D had a larger area under ROC,hsCRP had the highest sensitivity,and D-D sensitivity and specificity were higher,showing a good diagnostic efficiency,the efficiency of the combined prediction of hsCRP、WBC and D-D to SMPP was very high.