| Objective:To investigate the correlation between various clinical features and blood routines and the diagnosis of acute infection of MP in children with low Mycoplasma pneumoniae(MP)antibody titer,and to develop a clinical diagnosis scoring system based on predictive model.Methods:A total of 201 children with pneumonia with a low serum MP antibody level of 1:40 or 1:80 were enrolled in our hospital from December 2017 to June 2018.Among them,189 patients with complete data were included in the study.Analysis,all clinical characteristics and blood routine results were collected within 24 hours after admission,using acute and recovery serum MP antibody titer changes greater than or equal to 4 times the most MP acute infection diagnosis outcome.Statistical analysis of the comparison between groups was performed using independent sample t-test,non-parametric test,and chi-square test to assess whether there were differences between groups;use ROC curve to determine the boundary value and convert the continuous variable into two categories.Variables were established by logistic regression analysis to establish a predictive model,and a partial regression coefficient was used as a reference to establish a clinical scoring system.Statistical analysis was performed using SPSS 22.0 statistical software,and the ROC curve was plotted using Sigma Plot 12.5 software and EmpowerStats 2.16.1.Results:1.77 cases were diagnosed as MP infection group and 112 cases were diagnosed as non-MP infection group.The temperature of hospital admission,fever time,cough time,percentage of lymphocytes and CRP were different between groups.2.Cough time and CRP were confounding factors for the diagnosis of MP acute infection(P>0.05).The fever time,irritating cough,salivation and lymphocyte percentage were independent risk factors for the diagnosis of MP acute infection(P<0.05).3.Fitting the joint variables by binary logistic regression,and gradually removing the factors with less diagnostic value by the forward method,screening the starting heat time,irritating cough,salivation,and percentage of lymphocytes can be used to fit the joint diagnostic index(P values ??are less than 0.01),and the regression equation log(p/1-p)=-3.62092 +1.03660*(fever time)+1.80195*(whether irritating cough)+1.16888*(whether or not)+0.90309* Percentage of lymphocytes).4,based on regression analysis to produce a clinical scoring system,fever time is greater than or equal to 3 days to get 1 point,irritating cough scored 2 points,there are 1 point of salivation,blood routine percentage of lymphocytes more than 36% get 1 point,in A total score of more than 4 points is the best cutoff value for this scoring system.When the cutoff value is divided into 4,the sensitivity of the scoring system is 61.04%,the specificity is 73.21%,the positive likelihood ratio is 2.2788,the negative likelihood ratio is 0.5322,the diagnostic odds ratio is 4.2822,and the area under the ROC curve(AUC)is 0.74.Conclusion:1.The time of fever,irritating cough,salivation and percentage of lymphocytes are statistically different for the diagnosis of MP infection,which can be used as the basis for differential diagnosis.2,through the combination of fever time,irritating cough,salivation,lymphocyte percentage to make a clinical scoring system can improve the diagnostic efficacy of MP infection.3,the clinical scoring system score of more than 4 points,with a higher diagnostic sensitivity,specificity,can be used as an effective basis for the diagnosis of MP infection. |
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