Lactate Dehydrogenase as a Biomarker for Prediction of Refractory Mycoplasma pneumoniae Pneumonia in Children
Lactate Dehydrogenase as a Biomarker for Prediction of Refractory Mycoplasma pneumoniae Pneumonia in Children
复制标题
DOI：
10.4187/respcare.03920
复制
发表时间：
2015-10-01
期刊：
影响因子：
2.5
通讯作者：
Qian, Liling
中科院分区：
文献类型：
--
作者：
Lu, Aizhen;Wang, Chuankai;Qian, Liling
背景：糖皮质激素已被用于难治性肺炎支原体肺炎，并有有益的效果。本研究的目的是确定预测难治性肺炎支原体肺炎的生物标志物，及时启动类固醇治疗。方法：对2012年9月至2013年8月复旦大学儿童医院收治的肺炎支原体肺炎患儿进行前瞻性队列研究。入院时进行乳酸脱氢酶（LDH）和其他实验室检查，包括全血细胞计数、c反应蛋白、红细胞沉降率（ESR）、丙氨酸转氨酶、天冬氨酸转氨酶、α -羟基丁酸脱氢酶（HBDH）、肌酸激酶和肌酸激酶MB。根据难治性肺炎支原体肺炎的定义，将受试者分为难治性肺炎支原体肺炎和常见性肺炎支原体肺炎两组。分析了实验室检查结果的诊断价值。结果：共纳入653例受试者，其中难治性肺炎组300例，普通肺炎组353例。两组间性别分布无显著差异。难治性肺炎支原体肺炎组的平均年龄大于普通肺炎支原体肺炎组。与普通肺炎组比较，难治性肺炎组c反应蛋白、LDH、HBDH、谷丙转氨酶、天冬氨酸转氨酶、中性粒细胞水平显著升高，esr升高。Logistic回归分析显示，年龄、LDH、ESR是预测难治性肺炎支原体肺炎的重要因素。LDH与HBDH具有较强的相关性，经受试者工作特征曲线分析，LDH曲线下面积为0.718，临界值为379 IU/L； ESR曲线下面积为0.683，临界值为32.5 IU/L； HBDH曲线下面积为0.691，临界值为259.5 IU/L。结论：血清LDH可作为预测住院早期难治性肺炎支原体肺炎的生物标志物。(C) 2015代达罗斯企业
BACKGROUND: Corticosteroids have been used for refractory Mycoplasma pneumoniae pneumonia and have beneficial effects. The aim of this study was to identify the biomarkers for predicting refractory M. pneumoniae pneumonia in a timely fashion to initiate steroid therapy. METHODS: This was a prospective cohort study of children with M. pneumoniae pneumonia admitted to the Children's Hospital of Fudan University from September 2012 to August 2013. Lactate dehydrogenase (LDH) and other laboratory tests, including complete blood counts, C-reactive protein, erythrocyte sedimentation rate (ESR), alanine aminotransferase, aspartate aminotransferase, alpha-hydroxybutyrate dehydrogenase (HBDH), creatine kinase, and creatine kinase MB, were performed on admission. Based on the definition of refractory M. pneumoniae pneumonia, subjects were divided into 2 groups: refractory M. pneumoniae pneumonia and usual M. pneumoniae pneumonia. The diagnostic values of laboratory findings were analyzed. RESULTS: In total, 653 subjects were enrolled, including 300 in the refractory pneumonia group and 353 in the usual pneumonia group. There was no significant difference in sex distribution between the 2 groups. The average age in the refractory M. pneumoniae pneumonia group was greater than that in the usual M. pneumoniae pneumonia group. Compared with the usual pneumonia group, the refractory pneumonia group showed significantly higher levels of C-reactive protein, serum LDH, serum HBDH, serum alanine aminotransferase, serum aspartate aminotransferase, and neutrophils and higher ESRs. Logistic regression showed that age, LDH, and ESR were the significant factors in predicting refractory M. pneumoniae pneumonia. In addition, LDH and HBDH were strongly correlated, and receiver operating characteristic curve analysis showed that the area under the curve of LDH was 0.718 with a cutoff of 379 IU/L, that of ESR was 0.683 with a cutoff of 32.5 IU/L, and that of HBDH was 0.691 with a cutoff of 259.5 IU/L. CONCLUSIONS: Serum LDH can be used as a biomarker to predict refractory M. pneumoniae pneumonia at the early stage of hospitalization. (C) 2015 Daedalus Enterprises