Jeong Ji Eun, Soh Ji Eun, Kwak Ji Hee, Jung Hye Lim, Shim Jae Won, Kim Deok Soo, Park Moon Soo, Shim Jung Yeon
Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Pediatr. 2018 Aug;61(8):258-263. doi: 10.3345/kjp.2018.61.8.258. Epub 2018 Aug 15.
Macrolide-resistant Mycoplasma pneumoniae pneumonia (MPP) is characterized by prolonged fever and radiological progression despite macrolide treatment. Few studies have examined serum procalcitonin (PCT) level in children with MPP. We aimed to investigate the association of acute inflammation markers including PCT with clinical parameters in children with MPP.
A total of 147 children were recruited. The diagnosis of MPP relied on serial measurement of IgM antibody against mycoplasma and/or polymerase chain reaction. We evaluated the relationships between C-reactive protein (CRP), PCT, and lactate dehydrogenase (LDH) levels and white blood cell (WBC) counts, and clinical severity of the disease. We used multivariate logistic regression analysis to estimate the odds ratio for prolonged fever (>3 days after admission) and hospital stay (> 6 days), comparing quintiles 2-5 of the PCT levels with the lowest quintile.
The serum PCT and CRP levels were higher in children with fever and hospital stay than in those with fever lasting ≤ 3 days after admission and hospital stay ≤ 6 days. CRP level was higher in segmental/lobar pneumonia than in bronchopneumonia. The LDH level and WBC counts were higher in children with fever lasting for >3 days before compared to those with fever lasting for ≤ 3 days. The highest quintile of PCT levels was associated with a significantly higher risk of prolonged fever and/or hospital stay than the lowest quintile.
Serum PCT and CRP levels on admission day were associated with persistent fever and longer hospitalization in children with MPP.
大环内酯类耐药肺炎支原体肺炎（MPP）的特点是尽管接受了大环内酯类治疗，但仍持续发热且影像学有进展。很少有研究检测MPP患儿的血清降钙素原（PCT）水平。我们旨在研究包括PCT在内的急性炎症标志物与MPP患儿临床参数之间的关联。
共招募了147名儿童。MPP的诊断依赖于支原体IgM抗体的系列检测和/或聚合酶链反应。我们评估了C反应蛋白（CRP）、PCT和乳酸脱氢酶（LDH）水平与白细胞（WBC）计数以及疾病临床严重程度之间的关系。我们使用多因素逻辑回归分析来估计入院后发热持续时间>3天和住院时间>6天的比值比，将PCT水平的第2 - 5五分位数与最低五分位数进行比较。
发热和住院时间较长的患儿血清PCT和CRP水平高于入院后发热持续时间≤3天且住院时间≤6天的患儿。节段性/大叶性肺炎患儿的CRP水平高于支气管肺炎患儿。发热持续>3天的患儿的LDH水平和WBC计数高于发热持续≤3天的患儿。与最低五分位数相比，PCT水平最高的五分位数与发热持续时间延长和/或住院时间延长的风险显著更高相关。
入院当天的血清PCT和CRP水平与MPP患儿的持续发热和更长住院时间相关。
