Clinical Features and Biomarkers for Early Prediction of Refractory Mycoplasma Pneumoniae Pneumonia in Children

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
Qin Chen, Tingting Hu, Ling Wu, Lumin Chen
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Multiple logistic regression analysis was used to determine independent risk factors for RMPP. ROC curves were adopted to analyze the predictive values of biomarkers. <i>Results</i>. The RMPP group had more severe clinical symptoms and manifestations on imaging (including pleural effusion, pulmonary consolidation, and pulmonary atelectasis), a higher incidence of extrapulmonary complications, and a longer duration of hospital stays. Results of multiple logistic regression analysis showed that serum D-dimer (OR = 8.169, <span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"></path></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 9.2729\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.605,0)\"></path></g></svg>),</span></span> C-reactive protein (CRP) (OR = 1.146, <span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 9.2729\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.605,0)\"><use xlink:href=\"#g113-50\"></use></g></svg>),</span></span> and lactate dehydrogenase (LDH) (OR = 1.025, <span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 9.2729\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.605,0)\"><use xlink:href=\"#g113-50\"></use></g></svg>)</span></span> levels were independent risk factors for RMPP. The area under the receiver operating characteristic curve (AUROC) in RMPP prediction was 0.841, 0.870, and 0.893 for serum levels of D-dimer, CRP, and LDH, respectively (<span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 9.2729\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.605,0)\"><use xlink:href=\"#g113-50\"></use></g></svg>),</span></span> with a cutoff value of 1.47 ng/ml, 39.34 mg/L, and 379 IU/L, respectively. <i>Conclusions</i>. Serum D-dimer, CRP, and LDH levels were related to the severity of mycoplasma pneumoniae pneumonia in children and had potential as biomarkers for the early prediction of RMPP, suggesting great applicative values for the early diagnosis and timely intervention of children with RMPP in clinical practice.","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Emergency Medicine International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2024/9328177","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0

Abstract

Summary of Background Data.With the increasing incidence and mortality of refractory mycoplasma pneumonia (RMPP), the early diagnosis and treatment of RMPP have attracted more and more attention and have become a major concern in pediatrics. Objective. The study aimed to analyze the clinical characteristics of children with RMPP and to explore the biomarkers for the early prediction of RMPP, thus providing references for the clinical diagnosis and treatment of RMPP in children. Methods. Baseline clinical characteristics, clinical symptoms, physical examination, chest imaging, and laboratory indicators between children with RMPP and general refractory mycoplasma pneumoniae pneumonia (GMPP) were compared. Multiple logistic regression analysis was used to determine independent risk factors for RMPP. ROC curves were adopted to analyze the predictive values of biomarkers. Results. The RMPP group had more severe clinical symptoms and manifestations on imaging (including pleural effusion, pulmonary consolidation, and pulmonary atelectasis), a higher incidence of extrapulmonary complications, and a longer duration of hospital stays. Results of multiple logistic regression analysis showed that serum D-dimer (OR = 8.169, ), C-reactive protein (CRP) (OR = 1.146, ), and lactate dehydrogenase (LDH) (OR = 1.025, ) levels were independent risk factors for RMPP. The area under the receiver operating characteristic curve (AUROC) in RMPP prediction was 0.841, 0.870, and 0.893 for serum levels of D-dimer, CRP, and LDH, respectively (), with a cutoff value of 1.47 ng/ml, 39.34 mg/L, and 379 IU/L, respectively. Conclusions. Serum D-dimer, CRP, and LDH levels were related to the severity of mycoplasma pneumoniae pneumonia in children and had potential as biomarkers for the early prediction of RMPP, suggesting great applicative values for the early diagnosis and timely intervention of children with RMPP in clinical practice.
用于早期预测儿童难治性肺炎支原体肺炎的临床特征和生物标志物
背景资料摘要:随着难治性支原体肺炎(RMPP)发病率和死亡率的不断上升,RMPP 的早期诊断和治疗已引起越来越多的关注,并已成为儿科领域的一个重要问题。研究目的本研究旨在分析 RMPP 患儿的临床特征,探讨早期预测 RMPP 的生物标志物,从而为儿童 RMPP 的临床诊断和治疗提供参考。研究方法比较RMPP患儿和一般难治性肺炎支原体肺炎(GMPP)患儿的基线临床特征、临床症状、体格检查、胸部影像学检查和实验室指标。采用多元逻辑回归分析确定 RMPP 的独立危险因素。采用ROC曲线分析生物标志物的预测价值。结果RMPP组的临床症状和影像学表现(包括胸腔积液、肺部合并症和肺不张)更严重,肺外并发症的发生率更高,住院时间更长。多元逻辑回归分析结果显示,血清 D-二聚体(OR = 8.169,)、C 反应蛋白(CRP)(OR = 1.146,)和乳酸脱氢酶(LDH)(OR = 1.025,)水平是 RMPP 的独立危险因素。D-二聚体、CRP和LDH血清水平预测RMPP的接收者操作特征曲线下面积(AUROC)分别为0.841、0.870和0.893(),临界值分别为1.47纳克/毫升、39.34毫克/升和379 IU/升。结论血清D-二聚体、CRP和LDH水平与儿童肺炎支原体肺炎的严重程度有关,有可能成为早期预测RMPP的生物标志物,对临床早期诊断和及时干预RMPP患儿具有重要的应用价值。
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来源期刊
Emergency Medicine International
Emergency Medicine International EMERGENCY MEDICINE-
CiteScore
0.10
自引率
0.00%
发文量
187
审稿时长
17 weeks
期刊介绍: Emergency Medicine International is a peer-reviewed, Open Access journal that provides a forum for doctors, nurses, paramedics and ambulance staff. The journal publishes original research articles, review articles, and clinical studies related to prehospital care, disaster preparedness and response, acute medical and paediatric emergencies, critical care, sports medicine, wound care, and toxicology.
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