Ni Tong, Zhao Fei
Department of Pediatric, Affiliated Changzhou Children's Hospital of Nantong University, Changzhou, 213003, China.
Department of Nephrology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
BMC Infect Dis. 2025 May 22;25(1):733. doi: 10.1186/s12879-025-11132-w.
To investigate the clinical indicators that can predict myocardial damage in children with mycoplasma pneumoniae pneumonia (MPP) to help early identification and management.
The clinical data of 123 MPP children admitted from December 2023 to February 2024 in the affiliated Changzhou Children's Hospital of Nantong University were analyzed retrospectively. According to the creatine kinase isoenzyme (CK-MB) level, the children were divided into 61 cases without myocardial damage group and 62 cases with myocardial damage group. Clinical manifestations and laboratory parameters were compared between the two groups. The factors affecting myocardial damage in children with MPP were analyzed by logistic regression. The ROC curve analyzed the predictive value of relevant indicators for myocardial damage in children with MPP.
The incidence of abnormal electrocardiogram (ECG), extrapulmonary manifestations (except myocardial damage), white blood cell count (WBC), neutrophil/lymphocyte ratio (NLR), erythrocyte sedimentation rate (ESR), albumin and other myocardial enzyme parameters in the myocardial damage group were higher than those in the group without myocardial damage (P < 0.05), and the median age and platelet/neutrophil ratio (PNR) were lower than those in the group without myocardial damage (P < 0.05); there was no significant difference in general data such as gender, duration of fever, length of hospital stay, the incidence of severe pneumonia between the two groups (P > 0.05); multivariate logistic regression analysis showed that median age, NLR level and extrapulmonary manifestations (except myocardial damage) were the main factors affecting myocardial damage in children with MPP (P < 0.05); considering the interaction between NLR and PNR. We also performed ROC curve analysis for PNR. Among the univariate factors, PNR had the highest predictive value, and the specificity was as high as 86.9%. The combined area under the curve of the four indicators was 0.747, higher than that of the univariate factor (P < 0.001), with a predictive sensitivity of 83.9% and a specificity of 63.9%.
Children with MPP younger than 6.79 years have extrapulmonary manifestations (acute sinusitis, acute otitis media, etc.), NLR > 2.41, and PNR < 44.74 in blood routine are more likely to develop myocardial damage.
Not applicable.
探讨可预测肺炎支原体肺炎（MPP）患儿心肌损伤的临床指标，以助于早期识别与处理。
回顾性分析2023年12月至2024年2月南通大学附属常州儿童医院收治的123例MPP患儿的临床资料。根据肌酸激酶同工酶（CK-MB）水平，将患儿分为无心肌损伤组61例和有心肌损伤组62例。比较两组的临床表现及实验室参数。采用logistic回归分析MPP患儿心肌损伤的影响因素。绘制ROC曲线分析相关指标对MPP患儿心肌损伤的预测价值。
心肌损伤组心电图（ECG）异常、肺外表现（除心肌损伤外）、白细胞计数（WBC）、中性粒细胞/淋巴细胞比值（NLR）、红细胞沉降率（ESR）、白蛋白及其他心肌酶参数的发生率均高于无心肌损伤组（P＜0.05），中位年龄及血小板/中性粒细胞比值（PNR）低于无心肌损伤组（P＜0.05）；两组在性别、发热持续时间、住院时间、重症肺炎发生率等一般资料方面比较，差异无统计学意义（P＞0.05）；多因素logistic回归分析显示，中位年龄、NLR水平及肺外表现（除心肌损伤外）是影响MPP患儿心肌损伤的主要因素（P＜0.05）；考虑NLR与PNR的交互作用，对PNR也进行了ROC曲线分析。在单因素中，PNR预测价值最高，特异性高达86.9%。四个指标的联合曲线下面积为0.747，高于单因素（P＜0.001），预测敏感度为83.9%，特异性为63.9%。
年龄＜6.79岁、有肺外表现（急性鼻窦炎、急性中耳炎等）、NLR＞2.41且血常规PNR＜44.74的MPP患儿更易发生心肌损伤。
不适用。
