The Association between the Level of Plasma D-dimer and Disease Severity and Prognosis of <i>Mycoplasma pneumoniae</i> Pneumonia in Children

HUANG Mei-xia; ZHENG Yan; PAN Dan-feng; ZHOU Yun-lian; CHEN Zhi-min; ZHANG Yuan-yuan

doi:10.12182/20220160108

Volume 53 Issue 1

Jan. 2022

Turn off MathJax

Article Contents

Abstract

References

JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCES) > 2022 > 53(1): 160-165. > DOI: 10.12182/20220160108

HUANG Mei-xia, ZHENG Yan, PAN Dan-feng, et al. The Association between the Level of Plasma D-dimer and Disease Severity and Prognosis of Mycoplasma pneumoniae Pneumonia in Children[J]. Journal of Sichuan University (Medical Sciences), 2022, 53(1): 160-165. DOI: 10.12182/20220160108

Citation:

PDF (656 KB)

The Association between the Level of Plasma D-dimer and Disease Severity and Prognosis of Mycoplasma pneumoniae Pneumonia in Children

1.
Department of Pulmonology, Children’s Hospital, School of Medicine, Zhejiang University and National Clinical Research Center for Children’s Health, Hangzhou 310052, China
2.
Department of Pediatrics, Quzhou People’s Hospital of Zhejiang Province, Quzhou 324000, China
3.
Department of Pediatrics, the First People’s Hospital of Wenling, Wenling 317500, China

More Information

Corresponding author:
ZHANG Yuan-yuan, E-mail: chzyy@zju.edu.cn
Received Date: May 30, 2021
Revised Date: October 24, 2021
Available Online: January 23, 2022
Published Date: January 19, 2022

Abstract

Abstract

Objective To explore the association between the levels of plasma D-dimer and the disease severity and prognosis of Mycoplasma pneumoniae pneumonia (MPP) in children
Methods We retrospectively analyzed the clinical data of pediatric MPP patients who were admitted in our hospital between January 1, 2016 and December 31, 2018. According to the peak value of D-dimer, patients were divided into the normal group (D-dimer<0.55 mg/L) and the elevated group (D-dimer≥0.55 mg/L). Information regarding the demographics, clinical manifestations, auxiliary examinations and treatments of patients in the two groups was compared.
Results Of the 231 MPP patients included in the study, 70 were in the normal group and 161 were in the elevated group. The age of patients in the D-dimer elevated group was significantly higher than that of the normal group (P<0.01). Compared with the normal group, the elevated group had longer lengths of fever, hospital stay and antibiotic therapy, and more severe radiographic manifestations (all P<0.01). In addition, the incidence of extrapulmonary complications, refractory MPP and severe MPP in the elevated group were significantly higher than those in the normal group (P<0.01). As for the laboratory data, we found that neutrophils, C-reactive protein, lactate dehydrogenase, interleukin-6, interleukin-10 and interferon-γ were significantly higher in the elevated group than those in the normal group (P<0.05). After treatments, all patients showed improvement and were discharged, but the proportions of patients requiring glucocorticoids, bronchoscopy, thoracentesis were significantly higher in the elevated group than those in the normal group (P<0.05). Follow-up findings showed that the absorption rate of lung lesions 4 weeks after admission was significantly higher, the time needed for lung lesions absorption was significantly shorter, and the incidence of pulmonary sequelae was significantly lower in the normal group than those in the elevated group (all P<0.05). Correlation analysis showed that D-dimer level was positively correlated with the severity of pneumonia (r=0.272, P=0.000) and the incidence of pulmonary sequelae (r=0.235, P=0.000).
Conclusion Pediatric patients of MPP who had elevated plasma D-dimer had clinical manifestations that were more severe, required longer duration of treatment and longer recovery time for lung lesions, and were more likely to have pulmonary sequelae.
- Children,
- Mycoplasma pneumoniae,
- Pneumonia,
- D-dimer

FullText(HTML)

References (24)

References

[1]	WAITES K B, XIAO L, LIU Y, et al. Mycoplasma pneumoniae from the respiratory tract and beyond. Clin Microbiol Rev,2017,30(3): 747–809. DOI: 10.1128/CMR.00114-16
[2]	WANG X, ZHONG L J, CHEN Z M, et al. Necrotizing pneumonia caused by refractory Mycoplasma pneumonia pneumonia in children. World J Pediatr,2018,14(4): 344–349. DOI: 10.1007/s12519-018-0162-6
[3]	XU W, YANG H, LIU H, et al. Bronchoalveolar lavage T cell cytokine profiles and their association with lung function in children with Mycoplasma pneumoniae-associated bronchiolitis obliterans. Pediatr Pulmonol,2020,55(8): 2033–2040. DOI: 10.1002/ppul.24882
[4]	DABA M, KANG P B, SLADKY J, et al. Intravenous immunoglobulin as a therapeutic option for Mycoplasma pneumoniae encephalitis. J Child Neurol,2019,34(11): 687–691. DOI: 10.1177/0883073819854854
[5]	CARRARA C, ABBATE M, SABADINI E, et al. Acute kidney injury and hemolytic anemia secondary to Mycoplasma pneumoniae infection. Nephron,2017,137(2): 148–154. DOI: 10.1159/000478991
[6]	求伟玲, 王颖硕, 陈志敏. 肺炎支原体肺炎合并脾梗死一例. 中华儿科杂志,2017,55(9): 705–706. DOI: 10.3760/cma.j.issn.0578-1310.2017.09.016
[7]	BAO Y, LI X, WANG K, et al. Central retinal artery occlusion and cerebral infarction associated with Mycoplasma pneumonia infection in children. BMC Pediatr,2016,16(1): 210. DOI: 10.1186/s12887-016-0750-3
[8]	CHEN S, DING Y, VINTURACHE A, et al. Pulmonary embolism associated with mycoplasma in a child. Lancet Infect Dis,2020,20(11): 1347. DOI: 10.1016/S1473-3099(20)30253-X
[9]	WEITZ J I, FREDENBURGH J C, EIKELBOOM J W. A test in context: D-dimer. J Am Coll Cardiol,2017,70(19): 2411–2420. DOI: 10.1016/j.jacc.2017.09.024
[10]	TRITSCHLER T, KRAAIJPOEL N, LE GAL G, et al. Venous thromboembolism: Advances in diagnosis and treatment. JAMA,2018,320(15): 1583–1594. DOI: 10.1001/jama.2018.14346
[11]	GUNGOR B, ATICI A, BAYCAN O F, et al. Elevated D-dimer levels on admission are associated with severity and increased risk of mortality in COVID-19: A systematic review and meta-analysis. Am J Emerg Med,2021,39: 173–179. DOI: 10.1016/j.ajem.2020.09.018
[12]	胡亚美, 江载芳主编. 诸福棠实用儿科学. 第7版. 北京: 北京人民卫生出版社,2011: 1204–1205.
[13]	中华医学会儿科学分会呼吸学组, 《中华儿科杂志》编辑委员会. 儿童社区获得性肺炎管理指南(2013修订)(下). 中华儿科杂志,2013,51(11): 856–862. DOI: 10.3760/cma.j.issn.0578-1310.2013.11.012
[14]	王卫平, 孙锟, 常立文主编. 儿科学. 第9版. 北京: 北京人民卫生出版社,2018: 262.
[15]	JAIN S, WILLIAMS D J, ARNOLD S R, et al. Community-acquired pneumonia requiring hospitalization among U. S. children. N Engl J Med,2015,372(9): 835–845. DOI: 10.1056/NEJMoa1405870
[16]	PODDIGHE D. Extra-pulmonary diseases related to Mycoplasma pneumoniae in children: recent insights into the pathogenesis. Curr Opin Rheumatol,2018,30(4): 380–387. DOI: 10.1097/BOR.0000000000000494
[17]	LIU J, HE R, WU R, et al. Mycoplasma pneumoniae pneumonia associated thrombosis at Beijing Children’s hospital. BMC Infect Dis,2020,20(1): 51. DOI: 10.1186/s12879-020-4774-9
[18]	LI T, YU H, HOU W, et al. Evaluation of variation in coagulation among children with Mycoplasma pneumoniae pneumonia: a case-control study. J Int Med Res,2017,45(6): 2110–2118. DOI: 10.1177/0300060517709613
[19]	FAVRESSE J, LIPPI G, ROY P M, et al. D-dimer: Preanalytical, analytical, postanalytical variables, and clinical applications. Crit Rev Clin Lab Sci,2018,55(8): 548–577. DOI: 10.1080/10408363.2018.1529734
[20]	CERDA-MANCILLAS M C, SANTIAGO-GERMÁN D, ANDRADE-BRAVO B, et al. D-dimer as a biomarker of severity and adverse outcomes in patients with community acquired pneumonia. Arch Med Res,2020,51(5): 429–435. DOI: 10.1016/j.arcmed.2020.04.014
[21]	MISHRA K P, GANJU L, SINGH S B. Hypoxia modulates innate immune factors: A review. Int Immunopharmacol,2015,28(1): 425–428. DOI: 10.1016/j.intimp.2015.07.008
[22]	ITURRIAGA R, MOYA E A, DEL RIO R. Inflammation and oxidative stress during intermittent hypoxia: The impact on chemoreception. Exp Physiol,2015,100(2): 149–155. DOI: 10.1113/expphysiol.2014.079525
[23]	CHOI Y J, JEON J H, OH J W. Critical combination of initial markers for predicting refractory Mycoplasma pneumoniae pneumonia in children: A case control study. Respir Res,2019,20(1): 193. DOI: 10.1186/s12931-019-1152-5
[24]	ZHANG Y, MEI S, ZHOU Y, et al. Cytokines as the good predictors of refractory Mycoplasma pneumoniae pneumonia in school-aged children. Sci Rep, 2016, 6: 37037[2021-04-30]. https://dx.doi.org/10.1038/srep37037.

Relative Articles

Supplements (0)

Cited By

Cited by

Periodical cited type(31)

1.	李阳，郑海涵，孙静，李媛媛，陈必全. 肺炎支原体肺炎患儿肺泡灌洗液中肺炎支原体DNA载量与D-二聚体、乳酸脱氢酶水平及其预测价值. 创伤与急危重病医学. 2025(01): 27-31+37 .
2.	高建波，李娜，郑伟伟，许丽萍. 难治性支原体肺炎患儿血清D-二聚体、IL-21和TLR2表达及其临床诊断价值. 医药论坛杂志. 2025(03): 333-337 .
3.	李小娟，张科. 血清乳酸脱氢酶和D-二聚体及C反应蛋白与重症肺炎支原体肺炎患儿预后的关系. 医药论坛杂志. 2025(06): 625-630 .
4.	吴文彬，尤玉婷，黄晓强，洪婉倩，郑敬阳. NLR、LDH、DDR在儿童肺炎支原体坏死性肺炎评估诊断中的价值. 中外医学研究. 2025(09): 56-59 .
5.	郭丽丽，谢勇，张伟靖，马涛. 难治性MPP患儿血清炎症介质、D-D水平与支气管镜辅助治疗预后关系研究. 国际检验医学杂志. 2025(09): 1130-1134 .
6.	李连明. 肺炎支原体感染患儿外周血C反应蛋白、白细胞介素-6、D-二聚体的表达及诊断价值分析. 大医生. 2024(02): 103-105 .
7.	江晨，刘飞，王霄龙，何汉涛. SAA、内毒素联合SPA检测在重症肺炎诊治中的临床意义. 分子诊断与治疗杂志. 2024(04): 670-673 .
8.	尹莉，张丽，商树芹. RMPP患儿血清IL-17A、RANTES、GM-CSF水平变化及临床意义. 分子诊断与治疗杂志. 2024(04): 760-764 .
9.	王娟娟，陈智勇，尹同进，成胜，周力，蔡旭龙. 血清白细胞介素-17A、白细胞介素-10及白细胞介素-12p70对肺炎支原体肺炎患儿预后评估价值. 临床军医杂志. 2024(05): 501-504 .
10.	王雯娟，方天露，马晓蓉，李燕，戴缤. 老年卧床继发多重耐药菌重症肺炎患者血清CRP、PCT水平与预后的关系. 保健医学研究与实践. 2024(03): 33-37 .
11.	谢芳丽，应宇驰，欧阳琴琴. CRP、WBC及心肌酶谱与肺炎支原体肺炎患儿病情程度及治疗转归的关系. 实用中西医结合临床. 2024(09): 93-95+122 .
12.	严秋丽，张方园，陈颖青，施金金，钮文思. 新型指标HROX指数在儿童重症肺炎早期诊治中的应用价值研究. 中国临床新医学. 2024(08): 881-885 .
13.	李倩，丁翔宇，黄坤玲，刘建华. 儿童难治性肺炎支原体肺炎危险因素分析和预测模型构建. 国际呼吸杂志. 2024(08): 944-951 .
14.	袁小兰，肖子游，王感华. 白细胞计数C反应蛋白淀粉样蛋白A联合检测对支气管肺炎患儿病情严重程度的诊断价值. 山西医药杂志. 2024(17): 1342-1345 .
15.	夏明倩，李晨曦，蒋婷婷，刘晓萌，楚永涛，张雯静，毕晶. 血清PCT、IFN-γ及CRP与重症肺炎患儿病情程度及预后的相关性. 分子诊断与治疗杂志. 2024(10): 1992-1995 .
16.	姚淑英，俞兴华，叶桂姣，马华柱. 肺炎支原体肺炎患儿血清D-二聚体乳酸脱氢酶C-反应蛋白水平与病情的关系及预后风险列线图预测模型. 中国妇幼保健. 2024(22): 4417-4421 .
17.	李霞，谢晶，肖向丽. SAA/CRP、LDH、Gal-9水平在难治性肺炎支原体肺炎患儿病情及预后转归评估中的价值. 国际检验医学杂志. 2024(22): 2758-2761+2766 .
18.	贺媛，任国平，张翠燕，田甜，胡静宇. DPR对慢性骨髓增殖性肿瘤患者血栓形成的预测价值. 分子诊断与治疗杂志. 2024(11): 2186-2189 .
19.	杨彩琼，张敏，张迪雯，王随力，陆艳连，温晓灵，陈俊宇，温志红. 儿童重症肺炎支原体肺炎的危险因素分析. 中国临床新医学. 2024(11): 1227-1231 .
20.	王亚通，张东霞，丁雪辉，袁玉亮. 肺炎支原体肺炎外周血淋巴细胞CD3~+HLA-DR~+表达水平与疾病严重程度及预后关系研究. 创伤与急危重病医学. 2023(01): 53-55 .
21.	刘丽丽，关洋洋. 从“燥邪痹络”病机防治肺炎支原体肺炎探析. 中医药临床杂志. 2023(05): 854-858 .
22.	曾妮，张节平，吴文娟，邢晓莉，黄少祥. 肿瘤坏死因子受体1在肺炎支原体肺炎小鼠固有免疫应答中的调节机制. 中华医院感染学杂志. 2023(12): 1777-1782 .
23.	李前前，韩雪，四霄雪，高国财，潘丹萍. 肺宁排毒汤治疗儿童难治性肺炎支原体肺炎的临床疗效. 中国实验方剂学杂志. 2023(19): 145-150 .
24.	苏布德格日乐，刘伟民，斯琴格日勒，吉木斯古楞，宝高娃，吴春霞. 儿童肺炎支原体肺炎急性期高分辨率CT特征与血清炎症因子、病情严重程度及预后的相关性. 放射学实践. 2023(09): 1173-1177 .
25.	陆明琰，刘晓风，张裕祥，谢海燕，王晓丽. 血清APOC1、LDH及炎性感染指标在难治性支原体肺炎患儿中的表达水平及其与肺通气功能、预后效果的相关性分析. 现代生物医学进展. 2023(18): 3519-3523 .
26.	韩秋菊，高梦琦，郑云辉，卫飞燕，边伟帅. 机械通气下布地奈德混悬液联合异丙托溴铵雾化吸入治疗重症肺炎合并呼吸衰竭的临床疗效观察. 实用医院临床杂志. 2023(06): 109-112 .
27.	王小严. 血浆D-二聚体水平与儿童肺炎支原体肺炎严重程度及预后的相关性研究. 中国实用医药. 2023(23): 49-51 .
28.	安红雨，李超，周红，赵娜，于佳新. 盐酸氨溴索对老年肺炎患者氧合指数、D-二聚体和炎症指标的影响及对患者预后的预测效能. 中华老年多器官疾病杂志. 2023(12): 899-904 .
29.	王雨涵，朱绍云，汪受传. 从“风温痰热”论治儿童肺炎支原体肺炎. 南京中医药大学学报. 2023(12): 1237-1241 .
30.	罗云. 细菌感染性肺炎患儿血清PCT、hs-CRP、WBC、IL-6、Hb与病情严重程度的相关性分析. 武警医学. 2022(04): 277-280+286 .
31.	谢心怡，张阿敏，郑文宇，宁浩南，闫宪康，马辰晖，李福海. 基于准确病原的儿童大叶性肺炎炎症特点. 山东大学学报(医学版). 2022(12): 52-57 .

Other cited types(3)

Get Citation

PDF

XML

Article views (948) PDF downloads (88) Cited by(34)

The Association between the Level of Plasma D-dimer and Disease Severity and Prognosis of Mycoplasma pneumoniae Pneumonia in Children

Abstract

References

Cited by

Periodical cited type(31)

Other cited types(3)

Catalog

Export File

Citation

Format

Content