scholarly journals Clinical Significance of D-dimer Level in Refractory Mycoplasma Pneumoniae Pneumonia

2020 ◽  
Author(s):  
Xia Huang ◽  
Dan Li ◽  
Feng Liu ◽  
Deyu Zhao ◽  
Yifan Zhu ◽  
...  

Abstract Background Levels of serum D-dimer (D-D) in children with mycoplasma pneumoniae pneumonia (MPP) were assessed to explore the clinical significance of D-D level in refractory MPP(RMPP). Method: A total of 430 patients with MPP were enrolled between January 2015 and December 2015, and divided into a genera MPP (GMPP) group (n = 306) and a RMPP group (n = 124). Clinical data, D-D level, white blood cell (WBC) count, C-reactive protein (CRP), blood sedimentation (ESR), and lactate dehydrogenase (LDH) were compared between the two groups. Results (1) Hospitalization time, fever duration, WBC, CRP, LDH, ESR, and D-D were significantly higher in the RMPP group than in the GMPP group, (all P < 0.05). (2) Correlation analysis showed that D-D was positively correlated with WBC, CRP, ESR, and LDH, and could be used to jointly evaluate the severity of the disease. (3) The predictive values of WBC, CRP, ESR, LDH, and D-D for RMPP were further compared using area under the receiver operating characteristic curve(AUC) analysis. D-D had the highest predictive power for RMPP (AUC = 0.923, P < 0.01). When the D-D level was > 738 ng/ml, the predicted sensitivity of RMPP occurrence was 79.8% and the specificity was 93.5%. D-D level also had a good ability to predict pleural effusion and liver injury (AUC = 0.740, P < 0.01 and AUC = 0.812, P < 0.01, respectively). (4) After 1 week of treatment, the levels of D-D in both groups were lower than those before treatment (p < 0.01), but remained outside the normal range in 91.4% of participants, and were moderately or severely increased in 27.1% of the participants, all of whom were in the RMPP group. Conclusion Serum D-D levels were significantly increased in patients with RMPP, indicating that severe hypercoagulability and vascular endothelial injury with prolonged duration existed in this patient population. Increased levels of serum D-D may be used as an early predictor of RMPP and the occurrence of complications. Our findings provide a theoretical basis for the early diagnosis of RMPP, early intervention of hypercoagulability, and improvement of microcirculation therapy.

2020 ◽  
Author(s):  
Xia Huang ◽  
Dan Li ◽  
Feng Liu ◽  
Deyu Zhao ◽  
Yifan Zhu ◽  
...  

Abstract Background: The levels of serum D-dimer (D-D) in children with Mycoplasma pneumoniae pneumonia (MPP) were assessed to explore the clinical significance of D-D levels in refractory MPP (RMPP). Method: A total of 430 patients with MPP were enrolled between January 2015 and December 2015 and divided into a general MPP (GMPP) group (n=306) and a RMPP group (n=124). Clinical data, D-D level, white blood cell (WBC) count, proportion of neutrophils (N%), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), alanine transaminase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) were compared between the two groups. Multivariate logistic regression was performed to identify independent predictors of RMPP. Results: (1) Hospitalization time, preadmission fever duration, total fever duration, WBC, N %, CRP, LDH, ESR, ALT, AST, and D-D were significantly higher in the RMPP group than those in the GMPP group (all P<0.05). (2) Correlation analysis showed that D-D was positively correlated with WBC, CRP, ESR, and LDH, and could be used to jointly evaluate the severity of the disease. (3) Multivariate logistic regression analysis identified preadmission fever duration, CRP, LDH and DD as independent risk factors for RMPP (all P<0. 05). D-D had the highest predictive power for RMPP (P<0.01). The D-D level also had a good ability to predict pleural effusion and liver injury (all P<0.01). Conclusion: Serum D-D levels were significantly increased in patients with RMPP, indicating that excessive inflammatory response and vascular endothelial injury with prolonged duration existed in this patient population. Increased levels of serum D-D may be used as an early predictor of RMPP and the occurrence of complications. Our findings provide a theoretical basis for the early diagnosis of RMPP, early intervention and excessive inflammatory response in the pathogenesis of mycoplasma.


2020 ◽  
Author(s):  
Xia Huang ◽  
Dan Li ◽  
Feng Liu ◽  
Deyu Zhao ◽  
Yifan Zhu ◽  
...  

Abstract Background: The levels of serum D-dimer (D-D) in children with Mycoplasma pneumoniae pneumonia (MPP) were assessed to explore the clinical significance of D-D levels in refractory MPP (RMPP).Method: A total of 430 patients with MPP were enrolled between January 2015 and December 2015 and divided into a general MPP (GMPP) group (n=306) and a RMPP group (n=124). Clinical data, D-D level, white blood cell (WBC) count, proportion of neutrophils (N%), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), alanine transaminase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) were compared between the two groups. Multivariate logistic regression was performed to identify independent predictors of RMPP.Results: (1) Hospitalization time, preadmission fever duration, total fever duration, WBC, N %, CRP, LDH, ESR, ALT, AST, and D-D were significantly higher in the RMPP group than those in the GMPP group, (all P<0.05). (2) Correlation analysis showed that D-D was positively correlated with WBC, CRP, ESR, and LDH, and could be used to jointly evaluate the severity of the disease. (3) Multivariate logistic regression analysis identified preadmission fever duration, CRP, LDH and DD as independent risk factors for RMPP (all P<0. 05). D-D had the highest predictive power for RMPP (P<0.01).. The D-D level also had a good ability to predict pleural effusion and liver injury (all P<0.01). Conclusion: Serum D-D levels were significantly increased in patients with RMPP, indicating that excessive inflammatory response and vascular endothelial injury with prolonged duration existed in this patient population. Increased levels of serum D-D may be used as an early predictor of RMPP and the occurrence of complications. Our findings provide a theoretical basis for the early diagnosis of RMPP, early intervention and excessive inflammatory response in the pathogenesis of mycoplasma.


2020 ◽  
Author(s):  
Xia Huang ◽  
Dan Li ◽  
Feng Liu ◽  
Deyu Zhao ◽  
Yifan Zhu ◽  
...  

Abstract Background: The levels of serum D-dimer (D-D) in children with Mycoplasma pneumoniae pneumonia (MPP) were assessed to explore the clinical significance of D-D levels in refractory MPP (RMPP).Method: A total of 430 patients with MPP were enrolled between January 2015 and December 2015 and divided into a general MPP (GMPP) group (n=306) and a RMPP group (n=124). Clinical data, D-D level, white blood cell (WBC) count, proportion of neutrophils (N%), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), alanine transaminase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) were compared between the two groups. Multivariate logistic regression was performed to identify independent predictors of RMPP.Results: (1) Hospitalization time, preadmission fever duration, total fever duration, WBC, N %, CRP, LDH, ESR, ALT, AST, and D-D were significantly higher in the RMPP group than those in the GMPP group (all P<0.05). (2) Correlation analysis showed that D-D was positively correlated with WBC, CRP, ESR, and LDH, and could be used to jointly evaluate the severity of the disease. (3) Multivariate logistic regression analysis identified preadmission fever duration, CRP, LDH and DD as independent risk factors for RMPP (all P<0. 05). D-D had the highest predictive power for RMPP (P<0.01). The D-D level also had a good ability to predict pleural effusion and liver injury (all P<0.01). Conclusion: Serum D-D levels were significantly increased in patients with RMPP, indicating that excessive inflammatory response and vascular endothelial injury with prolonged duration existed in this patient population. Increased levels of serum D-D may be used as an early predictor of RMPP and the occurrence of complications. Our findings provide a theoretical basis for the early diagnosis of RMPP, early intervention and excessive inflammatory response in the pathogenesis of mycoplasma.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xia Huang ◽  
Dan Li ◽  
Feng Liu ◽  
Deyu Zhao ◽  
Yifan Zhu ◽  
...  

Abstract Background The levels of serum D-dimer (D-D) in children with Mycoplasma pneumoniae pneumonia (MPP) were assessed to explore the clinical significance of D-D levels in refractory MPP (RMPP). Method A total of 430 patients with MPP were enrolled between January 2015 and December 2015 and divided into a general MPP (GMPP) group (n = 306) and a RMPP group (n = 124). Clinical data, D-D level, white blood cell (WBC) count, proportion of neutrophils (N%), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), alanine transaminase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) were compared between the two groups. Multivariate logistic regression was performed to identify independent predictors of RMPP. Results (1) Hospitalization time, preadmission fever duration, total fever duration, WBC, N %, CRP, LDH, ESR, ALT, AST, and D-D were significantly higher in the RMPP group than those in the GMPP group (all P < 0.05). (2) Correlation analysis showed that D-D was positively correlated with WBC, CRP, ESR, and LDH, and could be used to jointly evaluate the severity of the disease. (3) Multivariate logistic regression analysis identified preadmission fever duration, CRP, LDH and DD as independent risk factors for RMPP (all P < 0. 05). D-D had the highest predictive power for RMPP (P < 0.01). The D-D level also had a good ability to predict pleural effusion and liver injury (all P < 0.01). Conclusion Serum D-D levels were significantly increased in patients with RMPP, indicating that excessive inflammatory response and vascular endothelial injury with prolonged duration existed in this patient population. Increased levels of serum D-D may be used as an early predictor of RMPP and the occurrence of complications. Our findings provide a theoretical basis for the early diagnosis of RMPP, early intervention and excessive inflammatory response in the pathogenesis of mycoplasma.


2021 ◽  
Author(s):  
Qi Cheng ◽  
Han Zhang ◽  
Yunxiao Shang ◽  
Yuetong Zhao ◽  
Ye Zhang ◽  
...  

Abstract BackgroundEarly prediction of bronchitis obliterans (BO) is of great significance to the improvement of the long-term prognosis of children caused by refractory mycoplasma pneumoniae pneumonia (RMPP). This study aimed to establish a nomogram model to predict the risk of BO in children due to RMPP.MethodsA retrospective observation was conducted to study the clinical data of children with RMPP (1-14 years old) during acute infection. According to whether there is BO observed in the bronchoscope, children were divided into BO and the non-BO groups. The multivariate logistic regression model was used to construct the nomogram model.Results141 children with RMPP were finally included, of which 65 (46.0%) children with RMPP were complicated by BO. According to the multivariate logistic regression analysis, WBC count, ALB level, consolidation range exceeding 2/3 of lung lobes, timing of macrolides, glucocorticoids or fiber bronchoscopy and plastic bronchitis were independent influencing factors for the occurrence of BO and were incorporated into the nomogram. The area under the receiver operating characteristic curve (AUC-ROC) value of nomogram was 0.899 (95% confidence interval [CI]: 0.848~0.950). The Hosmer-Lemeshow test showed good calibration of the nomogram (p=0.692).Conclusion: A nomogram model found by seven risk factor was successfully constructed and can use to early prediction of children with BO due to RMPP.


2017 ◽  
Vol 45 (6) ◽  
pp. 2110-2118 ◽  
Author(s):  
Tianhua Li ◽  
Haiying Yu ◽  
Weina Hou ◽  
Zhiyong Li ◽  
Chunfang Han ◽  
...  

Objective Acute organ embolism in children with Mycoplasma pneumoniae pneumonia (MPP) has been reported, but changes in coagulation are unclear. This study aimed to investigate changes in coagulation in children with MPP. Methods A total of 185 children with MMP (cases) and 117 healthy children (controls) were recruited. We measured prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and plasma fibrinogen (FIB) and D-dimer levels. Results Plasma FIB (3.39 ± 0.96 g/L vs 2.93 ± 0.6 6g/L, t = 4.50) and D-dimer (326.45 ± 95.62mg/L vs 263.93 ± 103.32mg/L, t=5.36) in MPP children were higher than controls and PT (9.54 ± 4.97S vs 11.48 ± 5.96S, t=3.05) and APTT (31.41 ± 12.01S vs 38.38 ± 11.72S, t=4.95) were shorter than controls. FIB, D-dimer, PT, and APTT were not different between the high IgM-titre and low-titre groups. The areas under the receiver operating characteristic curves in cases and controls for plasma FIB and D-dimer levels were 0.654 (95% confidence interval [CI], 0.593–0.716, P = 0.031) and 0.682 (95% CI, 0.619–0.744, P = 0.032), respectively. Conclusions Children with MPP have a higher risk of blood coagulation and thrombosis. Controlling these problems should be considered as soon as possible.


2020 ◽  
Author(s):  
yaoyao ling ◽  
Tongqiang Zhang ◽  
wei guo ◽  
Zhenli Zhu ◽  
Jiao Tian ◽  
...  

Abstract BACKGROUND: Analyze the clinical characteristics of Fulminant Mycoplasma pneumoniae pneumonia (FMPP), and identify the related factors predicting FMPP.METHODS: A retrospective case-control study was performed on 345 children with Mycoplasma pneumoniae pneumonia (MPP) hospitalized in our hospital from January 2017 to June 2019. The clinical features, laboratory data and radiological findings were compared between the FMPP group, refractory Mycoplasma pneumoniae pneumonia (RMPP)group and general Mycoplasma pneumoniae pneumonia (GMPP) group. RESULTS: FMPP patients (n=69) had a higher incidence of extra-pulmonary complications and more serious radiological findings(P<0.05), besides the days of fever and the days in the hospitals were longer. FMPP patients also need more complicated treatments(P<0.05). Meanwhile, the levels of white blood cell count(WBC), C-reactive protein(CRP), lactic dehydrogenase (LDH), interleukin (IL)-6, ferritin, D-dimer, fibrinogen(FG), alanine aminotransferase(ALT) and the percentage of neutrophils in the FMPP group were significantly higher than those in the RMPP group and the GMPP group (P<0.05). In ROC curve analysis, the percentage of neutrophils, WBC, CRP, LDH, IL-6, ferritin, D-dimer and ALT were contributed to identify FMPP patients. Multivariate logistic regression analysis showed that ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion have significant predictive effects on the early diagnosis of FMPP (P<0.01).CONCLUSION: FMPP patients presented more serious clinical manifestations. Ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion were clinical factors for FMPP.


2020 ◽  
Author(s):  
yaoyao ling ◽  
Tongqiang Zhang ◽  
Zhenli Zhu ◽  
Jiao Tian ◽  
yongsheng xu ◽  
...  

Abstract BACKGROUND: Analyze the clinical characteristics of Fulminant Mycoplasma pneumoniae pneumonia (FMPP), and explore the related factors predicting FMPP. METHODS: A retrospective case-control study was performed on 345 children with Mycoplasma pneumoniae pneumonia (MPP) hospitalized in our Hospital from January 2017 to June 2019. The clinical features, laboratory data and radiological findings were compared between the FMPP group, refractory Mycoplasma pneumoniae pneumonia (RMPP)group and general Mycoplasma pneumoniae pneumonia (GMPP) group. RESULTS: FMPP patients (n=69) had more severe presentations, higher incidence of extra-pulmonary complications and more serious radiological findings(P<0.05). And the days of fever and the days in hospital were longer, and FMPP patients also need more complicated treatments(P<0.05). Meanwhile, the levels of white blood cell count(WBC) ,C-reactive protein(CRP), lactic dehydrogenase (LDH), interleukin (IL)-6,ferritin, D-dimer, fibrinogen(FG),alanine aminotransferase(ALT) and the percentage of neutrophils in the FMPP group were significantly higher than those in the RMPP group and the GMPP group (both P<0.05). In ROC curve analysis, the percentage of neutrophils, WBC, CRP, LDH, IL-6, ferritin, D-dimer and ALT were contributed to identify FMPP patients. Multivariate logistic regression analysis showed that ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion had significant predictive effects on the early diagnosis of FMPP (P<0.01). Conclusion: FMPP patients presented more serious clinical manifestations. Ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion were high risk factors for FMPP.


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