实用医学杂志 ›› 2020, Vol. 36 ›› Issue (20): 2848-2851.doi: 10.3969/j.issn.1006⁃5725.2020.20.021

• 医学检查与临床诊断 • 上一篇    下一篇

血清乳酸脱氢酶联合白细胞介素18对儿童难治性肺炎支原体肺炎的预测作用

管峥,霍洁,袁晶,吴新萍   

  1. 扬州市妇幼保健院(江苏扬州225002)
  • 出版日期:2020-10-20 发布日期:2020-10-25
  • 通讯作者: 吴新萍E⁃mail:yz_wxp@126.com
  • 基金资助:
    扬州市科技计划项目社会发展(编号:YZ2018083)

Effect of LDH and IL ⁃ 18 on prediction of refractory mycoplasma pneumoniae pneumonia in children

GUAN Zheng,HUO Jie,YUAN Jing,WU Xinping   

  1. Yangzhou Maternal and Child Care Service Centre,Yangzhou 225002,China
  • Online:2020-10-20 Published:2020-10-25
  • Contact: WU Xinping E⁃mail:yz_wxp@126.com

摘要:

目的 探讨血清乳酸脱氢酶(lactic dehydrogenase,LDH)联合白细胞介素18(interleukin⁃18,IL⁃18)对儿童难治性肺炎支原体肺炎的早期预测作用。方法 对2018年12月至2019年11月在我院诊断为肺炎(支原体感染)的患儿进行回顾性分析。144 例患儿中难治性肺炎支原体肺炎(refractory mycoplasmapneumoniae pneumonia,RMPP)共有48例,普通肺炎支原体肺炎(general mycoplasma pneumoniae pneumonia,GMPP)为96例。选择我院同期行体检的健康儿40例为对照组。分析比较三组儿童LDH 和IL⁃18水平的差异。运用ROC曲线对RMPP的发病进行预测,确定特异性指标临界值。结果 三组间的数值差异均有统计学意义(P < 0.001);三组间的两两比较表明:LDH水平在三组差异有统计学意义;IL⁃18水平RMPP组与GMPP组、RMPP 组与对照组的比较有差异,但GMPP 组与对照组比较差异无统计学意义。当LDH 值为306.05U/L 时,AUC(曲线下面积)为0.95,RMPP 诊断出的敏感性是95.8%,特异性是85.4%;当IL⁃18 水平等于416.95 pg/mL时,AUC等于0.99,RMPP的敏感性是97.9%,特异性为99.0%。结论 早期及时检测LDH值和IL⁃18水平对预测RMPP患儿病情严重程度和尽早积极干预治疗及评估预后具有非常重要的临床意义。

关键词: 肺炎支原体肺炎, 难治性, 乳酸脱氢酶, 白细胞介素18, 预测

Abstract:

Objective To investigate the effect of serum lactate dehydrogenase(LDH)combined withinterleukin⁃18(IL⁃18)in early predicting refractory mycoplasma pneumoniae pneumonia(RMPP)in children.Methods A total of 144 cases diagnosed with mycoplasma pneumoniae pneumonia in the hospital during December2018 to November 2019 were involved in the study,including 48 cases of RMPP and 96 cases of general Mycoplasmapneumoniae(GMPP). Another group of 40 healthy children who came for health examination in our hospitalduring the same period were assigned as the control group. The levels of LDH and IL⁃18 in the three groups werecompared. ROC curve was used to predict the incidence of RMPP,and the critical value of specific index wasdetermined. Results There were significant differences in the LDH level among the three groups(P < 0.001)andthe level of IL⁃18 in the RMPP group was significantly different as compared to the levels of RMPP and controlgroups,but there was no significant difference between the GMPP and control groups. When LDH was 306.05 U/L,AUC(area under the curve)was 0.95,with the RMPP sensitivity and specificity of 95.8% and 85.4%,respectively;When the level of IL⁃18 was 416.95pg/ml,AUC was 0.99,with the RMPP sensitivity and specificity of 97.9% and99.0%,respectively. Conclusion Early and timely detection of LDH and IL⁃18 levels is of great clinical signifi⁃cance in the early prediction of severe RMPP,early intervention and evaluation of prognosis.

Key words: mycoplasma pneumoniae pneumonia, refractory, LDH, IL?18, prediction