Department of Pulmonology, Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin Pediatric Research Institute and Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, 300134, China.
Children's Clinical College of Tianjin Medical University, Tianjin, China.
Respir Res. 2024 Jul 4;25(1):266. doi: 10.1186/s12931-024-02892-1.
This study explored the relationship between inflammatory markers and glucocorticoid dosage upon admission.
We conducted a retrospective analysis of 206 patients with refractory Mycoplasma pneumoniae pneumonia (RMPP) admitted to a Children's Hospital from November 2017 to January 2022. Patients were categorized into three groups based on their methylprednisolone dosage: low-dose (≤ 2 mg/kg/d), medium-dose (2-10 mg/kg/d), and high-dose (≥ 10 mg/kg/d). We compared demographic data, clinical manifestations, laboratory findings, and radiological outcomes. Spearman's rank correlation coefficient was used to assess relationships between variables.
The median age was highest in the low-dose group at 7 years, compared to 5.5 years in the medium-dose group and 6 years in the high-dose group (P < 0.001). The body mass index (BMI) was also highest in the low-dose group at 16.12, followed by 14.86 in the medium-dose group and 14.58 in the high-dose group (P < 0.001). More severe radiographic findings, longer hospital stays, and greater incidence of hypoxia were noted in the high-dose group (P < 0.05). Additionally, significant increases in white blood cells, C-reactive protein, procalcitonin, lactate dehydrogenase (LDH), alanine transaminase, aspartate transaminase, ferritin, erythrocyte sedimentation rate, and D-dimer levels were observed in the high-dose group (P < 0.05). Specifically, LDH and ferritin were markedly higher in the high-dose group, with levels at 660.5 U/L and 475.05 ng/mL, respectively, compared to 450 U/L and 151.4 ng/mL in the medium-dose group, and 316.5 U/L and 120.5 ng/mL in the low-dose group. Correlation analysis indicated that LDH and ferritin levels were significantly and positively correlated with glucocorticoid dose (Spearman ρ = 0.672 and ρ = 0.654, respectively; P < 0.001).
Serum LDH and ferritin levels may be useful biomarkers for determining the appropriate corticosteroid dosage in treating children with RMPP.
本研究旨在探讨入院时炎症标志物与糖皮质激素剂量之间的关系。
我们对 2017 年 11 月至 2022 年 1 月期间在一家儿童医院收治的 206 例难治性肺炎支原体肺炎（RMPP）患儿进行了回顾性分析。根据甲泼尼龙剂量将患儿分为三组：低剂量（≤2mg/kg/d）、中剂量（2-10mg/kg/d）和高剂量（≥10mg/kg/d）。比较了三组患儿的人口统计学数据、临床表现、实验室检查和影像学结果。采用 Spearman 秩相关系数评估变量之间的关系。
低剂量组患儿的中位年龄最高（7 岁），中剂量组为 5.5 岁，高剂量组为 6 岁（P<0.001）。低剂量组患儿的体重指数（BMI）最高（16.12），中剂量组为 14.86，高剂量组为 14.58（P<0.001）。高剂量组患儿的影像学表现更严重，住院时间更长，缺氧发生率更高（P<0.05）。此外，高剂量组患儿的白细胞计数、C 反应蛋白、降钙素原、乳酸脱氢酶（LDH）、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、铁蛋白、红细胞沉降率和 D-二聚体水平显著升高（P<0.05）。具体而言，高剂量组的 LDH 和铁蛋白水平明显升高，分别为 660.5U/L 和 475.05ng/mL，中剂量组分别为 450U/L 和 151.4ng/mL，低剂量组分别为 316.5U/L 和 120.5ng/mL。相关性分析表明，LDH 和铁蛋白水平与糖皮质激素剂量呈显著正相关（Spearman ρ=0.672 和 ρ=0.654，均 P<0.001）。
血清 LDH 和铁蛋白水平可能是评估儿童 RMPP 患者糖皮质激素剂量的有用生物标志物。
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