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Abstract：
BACKGROUND: To compare the demographic and clinical features, laboratory and imaging findings in mycoplasma pneumoniae pneumonia (MPP) children with non-MPP (NMPP) children and general MPP (GMPP) children with refractory MPP (RMPP) children and analysis the relationship with the severity of disease.
METHODS: The study included 265 children with MPP and 230 children with NMPP in the Affiliated Changzhou No. 2 People\'s Hospital of Nanjing Medical University from 2020 to 2021. The children with MPP included RMPP (n = 85) and GMPP (n = 180). Demographic and clinical characteristics, laboratory and imaging findings of all children were measured as baseline data within 24 h after admission and the differences between MPP and NMPP, RMPP and GMPP patients were compared. ROC curves were used to evaluate the diagnostic and predictive value of different indicators for RMPP.
RESULTS: Fever duration and hospital stay in children with MPP were longer than those with NMPP. The number of patients with imaging features of pleural effusion, lung consolidation and bronchopneumonia in MPP group was significantly higher than that in NMPP group. Compared with NMPP group, the levels of C-reactive protein (CRP), procalcitonin (PCT), serum amyloid A (SAA), erythrocyte sedimentation rate (ESR), lactic dehydrogenase (LDH), prothrombin time (PT), fibrinogen (FIB) and D-dimer and inflammatory cytokines (interleukin [IL]-6, IL-8, IL-10 and IL-1β) in MPP group were significantly higher (P < 0.05). The clinical symptoms and pulmonary imaging findings were more severe in RMPP group. The levels of white blood cell (WBC), CRP, PCT, SAA, ESR, alanine aminotransferase (ALT), LDH, ferritin, PT, FIB, D-dimer and inflammatory cytokines in RMPP group were higher than those in GMPP group. There was no significant difference in the level of lymphocyte subsets between the RMPP and GMPP group. IL-6, IL-10, LDH, PT, D-dimer and lung consolidation were independent risk factors for RMPP. IL-6 levels and LDH activity were good predictors of RMPP.
CONCLUSIONS: In conclusion, there were differences in clinical characteristics and serum inflammatory markers between MPP group and NMPP group, RMPP group and GMPP group. IL-6, IL-10, LDH, PT and D-dimer can be used as predictive indicators for RMPP.
METHODS: The study included 265 children with MPP and 230 children with NMPP in the Affiliated Changzhou No. 2 People\'s Hospital of Nanjing Medical University from 2020 to 2021. The children with MPP included RMPP (n = 85) and GMPP (n = 180). Demographic and clinical characteristics, laboratory and imaging findings of all children were measured as baseline data within 24 h after admission and the differences between MPP and NMPP, RMPP and GMPP patients were compared. ROC curves were used to evaluate the diagnostic and predictive value of different indicators for RMPP.
RESULTS: Fever duration and hospital stay in children with MPP were longer than those with NMPP. The number of patients with imaging features of pleural effusion, lung consolidation and bronchopneumonia in MPP group was significantly higher than that in NMPP group. Compared with NMPP group, the levels of C-reactive protein (CRP), procalcitonin (PCT), serum amyloid A (SAA), erythrocyte sedimentation rate (ESR), lactic dehydrogenase (LDH), prothrombin time (PT), fibrinogen (FIB) and D-dimer and inflammatory cytokines (interleukin [IL]-6, IL-8, IL-10 and IL-1β) in MPP group were significantly higher (P < 0.05). The clinical symptoms and pulmonary imaging findings were more severe in RMPP group. The levels of white blood cell (WBC), CRP, PCT, SAA, ESR, alanine aminotransferase (ALT), LDH, ferritin, PT, FIB, D-dimer and inflammatory cytokines in RMPP group were higher than those in GMPP group. There was no significant difference in the level of lymphocyte subsets between the RMPP and GMPP group. IL-6, IL-10, LDH, PT, D-dimer and lung consolidation were independent risk factors for RMPP. IL-6 levels and LDH activity were good predictors of RMPP.
CONCLUSIONS: In conclusion, there were differences in clinical characteristics and serum inflammatory markers between MPP group and NMPP group, RMPP group and GMPP group. IL-6, IL-10, LDH, PT and D-dimer can be used as predictive indicators for RMPP.
摘要：
背景：为了比较人口统计学和临床特征，肺炎支原体肺炎(MPP)患儿、非MPP(NMPP)患儿和普通MPP(GMPP)患儿、难治性MPP(RMPP)患儿的实验室及影像学表现,分析其与病情严重程度的关系。
方法：该研究包括常州市附属医院的265名MPP儿童和230名NMPP儿童。2南京医科大学人民医院，2020年至2021年。MPP患儿包括RMPP(n=85)和GMPP(n=180)。人口统计学和临床特征，在入院后24小时内测量所有儿童的实验室和影像学检查结果作为基线数据，以及MPP和NMPP之间的差异，比较RMPP和GMPP患者。采用ROC曲线评价不同指标对RMPP的诊断和预测价值。
结果：MPP患儿的发热持续时间和住院时间长于NMPP患儿。有胸腔积液影像学特征的患者人数,MPP组肺实变和支气管肺炎发生率明显高于NMPP组。与NMPP组相比，C反应蛋白（CRP）水平，降钙素原(PCT),血清淀粉样蛋白A（SAA），红细胞沉降率（ESR），乳酸脱氢酶（LDH），凝血酶原时间（PT），MPP组纤维蛋白原(FIB)、D-二聚体和炎性细胞因子(白细胞介素[IL]-6、IL-8、IL-10、IL-1β)均显著升高(P<0.05)。RMPP组的临床症状和肺部影像学表现更为严重。白细胞（WBC）的水平，CRP,PCT,SAA,ESR,丙氨酸氨基转移酶（ALT），LDH,铁蛋白,PT,FIB,RMPP组D-二聚体和炎性细胞因子水平均高于GMPP组。RMPP组与GMPP组之间淋巴细胞亚群程度差别无统计学意义。IL-6,IL-10,LDH,PT,D-二聚体和肺实变是RMPP的独立危险因素。IL-6水平和LDH活性是RMPP的良好预测因子。
结论：结论：MPP组与NMPP组之间的临床特征和血清炎症指标存在差异，RMPP组和GMPP组。IL-6,IL-10,LDH,PT和D-二聚体可作为RMPP的预测指标。
方法：该研究包括常州市附属医院的265名MPP儿童和230名NMPP儿童。2南京医科大学人民医院，2020年至2021年。MPP患儿包括RMPP(n=85)和GMPP(n=180)。人口统计学和临床特征，在入院后24小时内测量所有儿童的实验室和影像学检查结果作为基线数据，以及MPP和NMPP之间的差异，比较RMPP和GMPP患者。采用ROC曲线评价不同指标对RMPP的诊断和预测价值。
结果：MPP患儿的发热持续时间和住院时间长于NMPP患儿。有胸腔积液影像学特征的患者人数,MPP组肺实变和支气管肺炎发生率明显高于NMPP组。与NMPP组相比，C反应蛋白（CRP）水平，降钙素原(PCT),血清淀粉样蛋白A（SAA），红细胞沉降率（ESR），乳酸脱氢酶（LDH），凝血酶原时间（PT），MPP组纤维蛋白原(FIB)、D-二聚体和炎性细胞因子(白细胞介素[IL]-6、IL-8、IL-10、IL-1β)均显著升高(P<0.05)。RMPP组的临床症状和肺部影像学表现更为严重。白细胞（WBC）的水平，CRP,PCT,SAA,ESR,丙氨酸氨基转移酶（ALT），LDH,铁蛋白,PT,FIB,RMPP组D-二聚体和炎性细胞因子水平均高于GMPP组。RMPP组与GMPP组之间淋巴细胞亚群程度差别无统计学意义。IL-6,IL-10,LDH,PT,D-二聚体和肺实变是RMPP的独立危险因素。IL-6水平和LDH活性是RMPP的良好预测因子。
结论：结论：MPP组与NMPP组之间的临床特征和血清炎症指标存在差异，RMPP组和GMPP组。IL-6,IL-10,LDH,PT和D-二聚体可作为RMPP的预测指标。
