Study Related To The Prediction Of Severe Pneumonia With Pleural Effusion In Children By D-dimer And Inflammatory Markers

Objective: To investigate the value of D-dimer and inflammatory markers in predicting severe pneumonia(severe community-acquired pneumonia CAP)with pleural effusion(pleural effusion PE)in children.Methods: The clinical data of 140 children with severe pneumonia who were hospitalized in our hospital from July 2017 to July 2021 were retrospectively analyzed.They were divided into two groups,one group was severe CAP without PE group(74 cases),one group was severe CAP with PE group(66 cases).The laboratory test indexes of the first test within 24 hours of admission were compared between the two groups.Such as white blood cell count(WBC),neutrophil ratio(N %),C-reactive protein(CRP),serum amyloid protein(SAA),procalcitonin(PCT),erythrocyte sedimentation rate(ESR),lactate dehydrogenase(LDH),D-dimer(D-D).To study the value of the above indexes in the prediction of pleural effusion in children with severe pneumonia.Results:(1)The levels of WBC,N %,CRP,SAA,PCT,ESR,LDH and D-D in severe CAP combined with PE group were higher than those in severe CAP group,and the differences were statistically significant(t=-3.036,-4.516,-3.710,-3.312,-3.174,-3.511,-6.260,-8.367,P < 0.01).When the lung inflammation is severe and the values of WBC,N %,CRP,SAA,PCT,ESR,LDH and D-D are high,we should be alert to whether the pneumonia is complicated with pleural effusion.(2)Spearman correlation analysis showed that serum D-D level was positively correlated with WBC,N %,CRP,SAA,PCT,ESR and LDH(r = 0.232 P< 0.006,r = 0.401 P < 0.001,r = 0.555 P < 0.001,r = 0.276 P < 0.001,r =0.241 P < 0.004,r = 0.472 P < 0.001,r = 0.569 P < 0.001),which could be used to evaluate the severity of the disease.(3)Binary Logistic regression analysis showed that PCT and D-D were independent risk factors for severe CAP complicated with PE(P < 0.05).ROC curve showed that D-D had a high predictive ability for severe CAP with PE.Conclusions: The combination of WBC,N %,CRP,SAA,PCT,ESR,LDH,D-D and other indicators has certain value in evaluating the severity of pneumonia in children.PCT and D-D are independent risk factors for severe CAP complicated with PE,and D-D has a good predictive ability for severe pneumonia complicated with pleural effusion in children.The increase of D-D level is related to excessive inflammatory reaction and vascular endothelial injury in children.Therefore,serum D-D has certain reference value for the prediction of severe pneumonia complicated with pleural effusion in children.