血清铁蛋白和乳酸脱氢酶在小儿难治性支原体肺炎外周血中的表达及与预后的相关性

目的观察小儿难治性支原体肺炎（RMPP）患者血清铁蛋白（SF）和乳酸脱氢酶（LDH）表达变化及其对预后预测价值。 方法收集2014年10月至2018年10月衡水市人民医院儿科住院治疗的94例RMPP患儿为RMPP组,同时选取轻型肺炎支原体肺炎（MPP）患儿为MPP组（60例）及健康体检儿童为对照组（60例）;依据是否存活将RMPP组患儿分为死亡组（43例）和生存组（51例）。检测RMPP组、MPP组及对照组儿童SF和LDH水平,分析RMPP组SF和LDH与患儿预后的相关性。利用Spearman秩相关分析法对RMPP组患儿预后进行有效评估。 结果RMPP组患儿外周血中LDH含量[（438.3 ± 18.5）IU/L]高于MPP组患儿[（254.3 ± 21.8）IU/L]和对照组[（136.8 ± 13.1）]IU/L,差异有统计学意义（t = 8.7、P = 0.001,t = 19.1、P = 0.001）。RMPP组患儿外周血中SF含量[（412.1 ± 20.6）ng/ml]高于MPP组患儿[（120.7 ± 13.3）ng/ml]和对照组[（96.9 ± 11.5）ng/ml],差异有统计学意义（t = 15.1、P = 0.001,t = 18.4、P = 0.001）。与生存组RMPP患儿比较,死亡组RMPP患儿LDH[（473.2 ± 23.2）IU/L vs.（416.4 ± 19.1）IU/L]和SF[（445.2 ± 20.1）ng/ml vs.（396.2 ± 17.6）ng/ml]水平显著升高,差异有统计学意义（t = 16.527、P = 0.037,t = 19.845、P = 0.015）。生存组RMPP患儿LDH和SF水平显著高于死亡组,差异均有统计学意义（t = 16.527、P = 0.037,t = 19.845、P = 0.015）。LDH的AUC（0.8）大于SF（0.7）,差异具有统计学意义（χ² = 5.735、P = 0.03）。LDH联合SF检测的灵敏度（90.3%）高于LDH检测（82.6%）（χ² = 5.292、P = 0.016）和SF检测（79.6%）（χ² = 5.369、P = 0.024）;LDH联合SF检测的特异度（88.4%）高于LDH检测（81.9%）（χ² = 6.408、P = 0.011）和SF检测（81.7%）（χ² = 6.278、P = 0.032）,差异均有统计学意义。Spearman秩相关分析显示,LDH和SF水平与RMPP患儿的预后呈正相关（r = 2.162、P = 0.015,r = 1.485、P = 0.022）。 结论与健康儿童和MPP患儿相比,RMPP患儿LDH和SF水平显著升高,且二者与RMPP患儿的预后密切相关,LDH和SF水平较高的患儿预后较好。

Expression of serum ferritin and lactate dehydrogenase in peripheral blood of children with refractory mycoplasma pneumonia and the correlation with prognosis

ObjectiveTo investigate the changes of serum ferritin (SF) and lactate dehydrogenase (LDH) expression of children with refractory Mycoplasma pneumonia (RMPP) and their prognostic value. MethodsFrom October 2014 to October 2018, a total of 94 children with RMPP hospitalized in Hengshui People’s Hospital were collected as RMPP group, while children with Mycoplasma pneumoniae pneumonia (MPP) were selected as MPP group (60 cases) and healthy children of physical examination as control group (60 cases). The children in RMPP group were divided into death group (43 cases) and survival group (51 cases) according whether survived. The levels of SF and LDH of children in RMPP group, MPP group and control group were detected, and the correlations between SF, LDH and prognosis of RMPP group were analyzed, respectively. The prognosis of cases in RMPP group was effectively evaluated by Spearman rank correlation analysis. ResultsThe level of LDH in peripheral blood of children in RMPP group [(438.3 ± 18.5) IU/L] was significant higher than those of children in MPP group [(254.3 ± 21.8) IU/L] and control group [(136.8 ± 13.1)] IU/L, with significant differences (t = 8.7, P = 0.001; t = 19.1, P = 0.001). The level of SF in peripheral blood of children in RMPP group [(412.1 ± 20.6) ng/ml] was significantly higher than those of MPP group [(120.7 ± 13.3) ng/ml] and control group [(96.9 ± 11.5] ng/ml), with significant differences (t = 15.1, P = 0.001; t = 18.4, P = 0.001). Compared with RMPP children in survival group, levels of LDH [(473.2 ± 23.2) IU/L vs. (416.4 ± 19.1) IU/L] and SF [(445.2 ± 20.1) ng/ml vs. (396.2 ± 17.6) ng/ml] increased significantly of death group, with significant differences (t = 16.527, P = 0.037; t = 19.845, P = 0.015). The levels of LDH and SF of children with RMPP in survival group were significantly higher than those of death group, with significant differences (t = 16.527, P = 0.037; t = 19.845, P = 0.015). The AUC (0.8) of LDH was larger than that of SF (0.7), with significant difference (χ² = 5.735, P = 0.03). The sensitivity of LDH combined with SF detection (90.3%) was higher than those of LDH detection (82.6%) and SF detection (79.6%), with significant differences (χ² = 5.292, P = 0.016; χ² = 5.369, P = 0.024). The specificity of LDH combined with SF detection (88.4%) was higher than LDH detection (81.9%) and SF detection (81.7%), with significant differences (χ² = 6.408, P = 0.011; χ² = 6.278, P = 0.032). Spearman rank correlation analysis showed positive correlations between levels of LDH, SF and prognosis of RMPP children (r = 2.162, P = 0.015; r = 1.485, P = 0.022). ConclusionsThe levels of LDH and SF of RMPP children were significantly increased compared with healthy children and MPP children, which were closely related to the prognosis of children; the higher the levels of LDH and SF, the better the prognosis of children.