支原体肺炎并发大叶性肺炎患儿实验室检测指标的诊断价值-现代医学

支原体肺炎并发大叶性肺炎患儿实验室检测指标的诊断价值

单位：1. 宜兴市人民医院检验科, 江苏宜兴 214200;
2. 南京医科大学流行病学系, 江苏南京 210029;
3. 南京医科大学附属儿童医院医务处, 江苏南京 210004

分类号：R725.6

出版年·卷·期（页码）：2025·53·第一期（28-34）

摘要：

目的: 比较单纯支原体患儿与支原体肺炎并发大叶性肺炎患儿实验室检测指标差异，探讨差异实验室指标对支原体肺炎并发大叶性肺炎的诊断价值。方法: 选取2023年11月至2023年12月无锡市儿童医院收治的103例支原体肺炎患儿，收集患儿住院期间各项血常规指标、感染指标、细胞因子和生化指标，根据患儿是否并发大叶性肺炎将其分为并发组和非并发组。将两组患儿的实验室指标进行单因素分析，对有统计学差异的指标建立ROC曲线评价对支原体肺炎病儿并发大叶肺炎的联合诊断价值。结果: 103例支原体肺炎患儿中共23例并发大叶性肺炎，合并发生率为22.33%。并发组患儿二氧化碳结合力(CO₂CP)、丙氨酸氨基转移酶(ALT)均显著高于非并发组(P<0.05)，谷草转氨酶(AST)/ALT显著低于非并发组(P<0.05)；三者联合诊断ROC曲线下面积(AUC)为0.707(95%CI 0.577～0.836)，高于CO₂CP(AUC=0.648，95% CI 0.501～0.794)、ALT(AUC=0.665，95%CI 0.541～0.788)和AST/ALT(AUC=0.665；95%CI 0.545～0.786)的任一单个指标，具有较高的联合诊断价值。结论: 支原体肺炎患儿并发大叶性肺炎组与非并发组生化指标差异有统计学意义，CO₂CP、ALT和 AST/ALT联合诊断可作为支原体肺炎患儿并发大叶肺炎的诊断指标，为支原体肺炎并发大叶性肺炎的临床诊疗提供一定依据。

Objective: To compare the laboratory test indicators of children with simple mycoplasma infection and those with mycoplasma pneumonia complicated with lobar pneumonia, and to explore the diagnostic value of the differential laboratory indicators for mycoplasma pneumonia complicated with lobar pneumonia. Methods: A total of 103 children with mycoplasma pneumonia admitted to the Children's Hospital from November 2023 to December 2023 were selected, and their blood routine indicators, infection indicators, cytokines, and biochemical indicators were collected during their hospitalization. The children were divided into complication group and non-complication group according to whether they were complicated with lobar pneumonia or not. The laboratory indicators of the two groups were analyzed by univariate analysis, and the receiver operating characteristic(ROC) curve was established to evaluate the combined diagnostic value of the differential laboratory indicators for children with mycoplasma pneumonia complicated with lobar pneumonia. Results: Among the 103 children with mycoplasma pneumonia, 23 had lobar pneumonia, with a combined incidence of 22.33%. The carbondioxide combining power(CO₂CP) and alanine transaminase(ALT) levels of the children with lobar pneumonia were significantly higher than those of the children without(P<0.05), while the aspartate transaminase(AST)/ALT ratio was significantly lower than that of the children without lobar pneumonia(P<0.05). The combined diagnostic value of CO₂CP, ALT, and AST/ALT was 0.707(95%CI 0.577-0.836), which was higher than the diagnostic value of any single indicator, including CO₂CP(AUC=0.648;95%CI 0.501-0.794)，ALT(AUC=0.665；95%CI 0.541-0.788) and AST/ALT(AUC=0.665；95%CI 0.545-0.786), indicating that they had higher combined diagnostic value. Conclusion: There are statistical differences in biochemical indicators between children with mycoplasma pneumonia complicated with lobar pneumonia and those without. The combination of CO₂CP, ALT, and AST/ALT can be used as a diagnostic index for children with mycoplasma pneumonia complicated with lobar pneumonia, which provides certain basis for clinical diagnosis and treatment of mycoplasma pneumonia complicated with lobar pneumonia.

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