摘要
目的 探讨血清KL-6对儿童难治性肺炎支原体肺炎(RMPP)的预测价值。方法 收集某院2018年1月1日-2020年12月31日收治的90例肺炎支原体肺炎患儿,将经大环内酯类抗菌药物治疗1周以上,仍表现持续发热、影像学加重的患儿设为难治组(30例),余下60例设为普通组,比较两组患儿临床资料信息、实验室指标、影像学表现等差异,进一步采用Logistic回归分析明确RMPP发生的危险因素,并绘制ROC曲线寻找KL-6最佳截断值,分析KL-6对预测RMPP发生的价值。结果 普通组与难治组在合并高热、皮肤损害、发热时间、气促、WBC、PLT、Hb、N、CRP、GPT、AST、PCT、MP-DNA载量、KL-6、LDH、胸腔积液、肺实变、肺不张等方面差异有统计学意义(P<0.05)。Logistic回归分析结果显示,合并高热、发热时间长、气促、KL-6、肺实变、肺不张是RMPP发生的独立危险因素(P<0.05)。绘制ROC曲线结果显示,当KL-6为4.73 U/ml时ROC曲线下面积为0.792(95%CI:0.729~0.903),此时预测RMPP的敏感性与特异性分别为76.67%(23/30)、80.00%(48/60)。结论 KL-6在RMPP患儿血清中表达较高,同时也是RMPP发生的独立危险因素,检测KL-6表达对评估RMPP患者预后具有一定的指导意义。当KL-6最佳截断值为4.73 U/ml时预测RMMP发生的价值最高。
Objectives This study aims to explore the predictive value of serum KL-6 in children with refractory pneumoniae pneumonia(RMPP).Methods A total of 90 children with Mycoplasma pneumoniae pneumonia who were admitted to a hospital from January 1, 2018 to December 31, 2020 were collected.Children with persistent fever and imaging aggravation after treatment with macrolide antibiotics for more than 1 week were set as the refractory group(30 cases). The remaining 60 cases were set as the ordinary group.The differences in clinical data, laboratory indicators, and imaging findings were compared between the two groups. Logistic regression analysis was further used to identify the risk factors for the occurrence of RMPP, the ROC curve was drawn to find the best cut-off value of KL-6, and the value of KL-6 in predicting the occurrence of RMPP was analyzed.Results The two groups had statistically significant differences in combined high fever, skin damage, heating time, shortness of breath, WBC,PLT, Hb, N, CRP, GPT, AST, PCT, MP-DNA load,KL-6,LDH,pleural effusion, lung parenchyma, and atelectasis(P<0.05). Logistic regression analysis showed that combined high fever, prolonged fever, shortness of breath, KL-6, lung consolidation, and atelectasis were independent risk factors for RMPP(P<0.05). The ROC curve indicated that when KL-6 was 4.73 U/ml, the area under the ROC curve was 0.792(95%CI:0.729~0.903). At this time, the sensitivity and specificity of predicting RMPP were 76.67%(23/30) and 80.00%(48/60) respectively.Conclusions KL-6 is highly expressed in the serum of children with RMMP, and it is also an independent risk factor for the occurrence of RMPP. The detection of KL-6 expression has a certain guiding significance for evaluating the prognosis of RMMP patients. When the best cut-off value of KL-6 is 4.73 U/ml, the value of predicting the occurrence of RMMP is the highest.
作者
李芳
金晓莉
宋义琴
Li Fang;Jin Xiaoli;Song Yiqin(Baoding Children's Hospital,Baoding Children's Respiratory and Digestive Diseases Clinical Research Key Laboratory,HeBei,BaoDing,071000,China;不详)
出处
《中国病案》
2023年第1期102-105,共4页
Chinese Medical Record
基金
保定市科技计划项目(17ZF031)。
