He Wenyi, Yin Jiansong, Wan Yu
Clin Lab. 2022 Dec 1;68(12). doi: 10.7754/Clin.Lab.2022.211132.
As a common pediatric respiratory disease, Mycoplasma pneumoniae pneumonia (MPP) accounts for 20 - 30% of acquired pneumonia in children, with a rising morbidity rate annually. We aimed to explore the correlations of different serological parameters with the severity and prognosis of MPP children.
A total of 108 MPP children were divided into severe group (n = 58) and mild group (n = 50). The serum levels of triglycerides, HDL-C, LDL-C, erythrocyte sedimentation rate (ESR), D-dimer (DD), lactate dehydrogenase (LDH), interleukin-6 (IL-6), galectin-3 (Gal-3), homocysteine (Hcy), and procalcitonin (PCT) were measured. Receiver operating characteristic (ROC) curves were plotted to analyze their predictive values for poor prognosis. They were followed up for 6 months and assigned into good and poor prognosis groups. Multivariate logistic regression analysis was performed to explore the serological parameters affecting prognosis. A prediction model was established.
In acute and recovery phases, the levels of ESR, DD, LDH, IL-6, Gal-3, Hcy, and PCT in the severe group were significantly higher than those in the mild group (p < 0.05). Prediction combining various serological parameters had the highest value for poor prognosis. ESR, DD, LDH, IL-6, Gal-3, Hcy, and PCT levels were independent risk factors. The concordance index of the nomogram model established using these factors was 0.745 (95% CI: 0.684 - 0.830). The area under the ROC curve was 0.726 (95% CI: 0.701 - 0.815). The predicted probability of the model was consistent with the actual one, showing high accuracy.
Serum levels of ESR, DD, LDH, IL-6, Gal-3, Hcy, and PCT are closely correlated with the severity and prognosis of MPP children, which provide references for prognostic evaluation. Prediction combining these indices is more valuable than that using a single index.
肺炎支原体肺炎（MPP）作为一种常见的儿科呼吸道疾病，占儿童获得性肺炎的20%-30%，且发病率逐年上升。我们旨在探讨不同血清学参数与MPP患儿病情严重程度及预后的相关性。
将108例MPP患儿分为重症组（n = 58）和轻症组（n = 50）。检测血清甘油三酯、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、红细胞沉降率（ESR）、D-二聚体（DD）、乳酸脱氢酶（LDH）、白细胞介素-6（IL-6）、半乳糖凝集素-3（Gal-3）、同型半胱氨酸（Hcy）和降钙素原（PCT）水平。绘制受试者工作特征（ROC）曲线分析其对预后不良的预测价值。对患儿进行6个月随访并分为预后良好组和预后不良组。进行多因素逻辑回归分析以探讨影响预后的血清学参数。建立预测模型。
在急性期和恢复期，重症组的ESR、DD、LDH、IL-6、Gal-3、Hcy和PCT水平显著高于轻症组（p < 0.05）。多种血清学参数联合预测对预后不良的价值最高。ESR、DD、LDH、IL-6、Gal-3、Hcy和PCT水平是独立危险因素。使用这些因素建立的列线图模型的一致性指数为0.745（95%CI：0.684 - 0.830）。ROC曲线下面积为0.726（95%CI：0.701 - 0.815）。模型预测概率与实际概率一致，显示出较高的准确性。
血清ESR、DD、LDH、IL-6、Gal-3、Hcy和PCT水平与MPP患儿的病情严重程度及预后密切相关，可为预后评估提供参考。联合这些指标进行预测比单一指标更有价值。
