Department of Allergy, Gansu Maternal and Child Health Hospital, First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou, China.
Department of Allergy, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China.
Medicine (Baltimore). 2024 Oct 11;103(41):e39665. doi: 10.1097/MD.0000000000039665.
Mycoplasma pneumoniae is a significant cause of respiratory infections in children, often leading to severe pneumonia. This study aimed to assess the clinical relevance of interferon-gamma (interferon-γ), D-dimer, lactate dehydrogenase (LDH), and C-reactive protein (CRP) as biomarkers in the severity of mycoplasma pneumonia in pediatric patients.
In this prospective study, 203 pediatric patients with mycoplasma pneumonia were classified into mild (123 patients) and severe (80 patients) groups. Biomarkers including interferon-γ, D-dimer, LDH, and CRP were measured and analyzed. Statistical methods employed included Pearson and Spearman correlation analyses, logistic regression, and receiver operating characteristic curve analysis.
The severe group exhibited significantly higher median and interquartile ranges for interferon-γ, D-dimer, LDH, and CRP compared to the mild group. Logistic regression identified IL-10, IL-6, interferon-γ, tumor necrosis factor-alpha, D-dimer, and LDH as independent predictors of severity, with the model achieving 92% accuracy. Receiver operating characteristic curve analysis showed optimal diagnostic efficacy for interferon-γ, D-dimer, and LDH, with the best threshold values being 8.11, 0.64, and 379, respectively. A significant positive correlation was observed between IL-6 and LDH, as well as between interferon-γ and D-dimer.
This study showed that interferon-γ >8.11, D-dimer >0.64, and LDH >379 have an important role in the assessment of severe mycoplasma pneumonia.
肺炎支原体是儿童呼吸道感染的重要病因，常导致重症肺炎。本研究旨在评估干扰素-γ（IFN-γ）、D-二聚体、乳酸脱氢酶（LDH）和 C 反应蛋白（CRP）作为儿童肺炎支原体严重程度生物标志物的临床相关性。
在这项前瞻性研究中，将 203 例肺炎支原体肺炎患儿分为轻症（123 例）和重症（80 例）两组。检测并分析了 IFN-γ、D-二聚体、LDH 和 CRP 等生物标志物。采用 Pearson 和 Spearman 相关分析、Logistic 回归和受试者工作特征曲线（ROC）分析等统计学方法。
与轻症组相比，重症组 IFN-γ、D-二聚体、LDH 和 CRP 的中位数和四分位数范围均显著升高。Logistic 回归分析显示，IL-10、IL-6、IFN-γ、肿瘤坏死因子-α、D-二聚体和 LDH 是严重程度的独立预测因子，该模型的准确率为 92%。ROC 曲线分析显示，IFN-γ、D-二聚体和 LDH 的诊断效能最佳，最佳截断值分别为 8.11、0.64 和 379。IL-6 与 LDH 以及 IFN-γ 与 D-二聚体之间呈显著正相关。
本研究表明，IFN-γ>8.11、D-二聚体>0.64 和 LDH>379 对评估严重肺炎支原体肺炎具有重要作用。
