Zhang Yuwen, Zhai Yuanpeng, Qi Shuai, Huang Dan, Wang Jingjing, Wang Linyan, Dong Xuemei, Sun Zhipeng, Yin Jiaojiao, Zhang Chong, Wang Weikai
School of Public Health, Gansu University of Chinese Medicine, Lanzhou, Gansu, People's Republic of China.
Department of Clinical Laboratory, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu, People's Republic of China.
PLoS One. 2025 Jun 3;20(6):e0321454. doi: 10.1371/journal.pone.0321454. eCollection 2025.
Mycoplasma pneumoniae is a common cause of pneumonia in children over 5 years of age. Cell Population Data (CPD) is valuable for screening various diseases, including certain infections and myeloproliferative disorders, but less used in the diagnosis of children mycoplasma pneumoniae pneumonia (MPP).
To improve the diagnostic efficacy and severity assessment of MPP in children by combining CPD with inflammatory markers.
This study was conducted at the Gansu Provincial Maternity and Child-care Hospital, China. The data was accessed on 01.10.2024 for the purpose of research. A retrospective study from 01.10. 2022-01.01.2024 included three groups of children aged 5-9 years: 1) those with MPP (n = 240), of which 73 were mild, 167 were severe; 2) those with bacterial pneumonia (n = 52); and 3) those with health check-ups (n = 340). CPD indicators were measured by Sysmex XN-9000 (Kobe, Japan) hematology analyzer. Inflammatory markers included PCT (procalcitonin), LDH (lactate dehydrogenase), CK-MB (creatine kinase isoenzyme), CRP (c-reactive protein), SAA (serum amyloid A), APTT (activated partial thromboplastin time), FIB (fibrinogen). The differences and correlation of parameters between three groups were analyzed and receiver operating characteristic (ROC) analysis was performed.
Most of the leukocyte parameter indices showed statistically significant differences between the MPP group and the healthy physical examination group (p < 0.05). Compared with bacterial pneumonia group, inflammatory markers were not correlated with the occurrence of MPP (p > 0.05), while LY-X and NE-WY were negatively correlated with the occurrence of MPP (p < 0.05). ROC analysis showed that the areas under the curve (AUC) for LY-X and NE-WY were 0.707 and 0.736, respectively. Additionally, LY-WY and MO-WZ are positively correlated with the severity of MPP (p < 0.05), and the AUC for MO-WZ was 0.709. Among the inflammatory markers, the AUC for SAA was 0.828, and combining SAA with MO-WZ increased the AUC to 0.861 in distinguishing mild from severe MPP.
Peripheral blood leukocyte parameters may have clinical application value for the early diagnosis and disease progression assessment of MPP.
肺炎支原体是5岁以上儿童肺炎的常见病因。细胞群体数据（CPD）对于筛查各种疾病，包括某些感染和骨髓增殖性疾病很有价值，但在儿童支原体肺炎（MPP）的诊断中应用较少。
通过将CPD与炎症标志物相结合，提高儿童MPP的诊断效能和病情严重程度评估。
本研究在中国甘肃省妇幼保健院进行。为了研究目的，于2024年10月1日获取数据。一项2022年10月1日至2024年1月1日的回顾性研究纳入了三组5至9岁的儿童：1）MPP患儿（n = 240），其中73例为轻度，167例为重度；2）细菌性肺炎患儿（n = 52）；3）健康体检儿童（n = 340）。CPD指标通过Sysmex XN - 9000（日本神户）血液分析仪测量。炎症标志物包括降钙素原（PCT）、乳酸脱氢酶（LDH）、肌酸激酶同工酶（CK - MB）、C反应蛋白（CRP）、血清淀粉样蛋白A（SAA）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）。分析三组之间参数的差异和相关性，并进行受试者工作特征（ROC）分析。
大多数白细胞参数指标在MPP组和健康体检组之间存在统计学显著差异（p < 0.05）。与细菌性肺炎组相比，炎症标志物与MPP的发生无关（p > 0.05），而淋巴细胞X（LY - X）和中性粒细胞W（NE - WY）与MPP的发生呈负相关（p < 0.05）。ROC分析显示，LY - X和NE - WY的曲线下面积（AUC）分别为0.707和0.736。此外，淋巴细胞W（LY - WY）和单核细胞Z（MO - WZ）与MPP的严重程度呈正相关（p < 0.05），MO - WZ的AUC为0.709。在炎症标志物中，SAA的AUC为0.828，将SAA与MO - WZ相结合可将区分轻度与重度MPP的AUC提高至0.861。
外周血白细胞参数可能对MPP的早期诊断和病情进展评估具有临床应用价值。
