nCD64、CRP联合LDH对儿童难治性肺炎支原体肺炎的诊断价值

doi:10.11958/20252783

天津医药 ›› 2025, Vol. 53 ›› Issue (12): 1246-1250.doi: 10.11958/20252783

nCD64、CRP联合LDH对儿童难治性肺炎支原体肺炎的诊断价值

王娥(), 张培, 霍影, 季嘉玲, 丁玲, 张爱青()

南京医科大学第四附属医院儿科（邮编210031）

收稿日期:2025-08-27 修回日期:2025-09-04 出版日期:2025-12-15 发布日期:2025-12-08
通讯作者: ^△E-mail：njaiqing@njmu.edu.cn
作者简介:王娥（1996），女，医师，主要从事儿童呼吸及肾脏系统疾病方面研究。E-mail：1123051618@qq.com
基金资助:
江苏省妇幼保健协会科研项目(FYX202330)

Diagnostic value of the combination of serum neutrophil CD64, CRP and LDH in children with refractory Mycoplasma pneumoniae pneumonia

WANG E(), ZHANG Pei, HUO Ying, JI Jialing, DING Ling, ZHANG Aiqing()

Department of Pediatrics, the Fourth Affiliated Hospital of Nanjing Medical University, Nanjing 210031, China

Received:2025-08-27 Revised:2025-09-04 Published:2025-12-15 Online:2025-12-08
Contact: ^△E-mail：njaiqing@njmu.edu.cn

王娥, 张培, 霍影, 季嘉玲, 丁玲, 张爱青. nCD64、CRP联合LDH对儿童难治性肺炎支原体肺炎的诊断价值[J]. 天津医药, 2025, 53(12): 1246-1250.

WANG E, ZHANG Pei, HUO Ying, JI Jialing, DING Ling, ZHANG Aiqing. Diagnostic value of the combination of serum neutrophil CD64, CRP and LDH in children with refractory Mycoplasma pneumoniae pneumonia[J]. Tianjin Medical Journal, 2025, 53(12): 1246-1250.

摘要/Abstract

摘要：

目的探讨中性粒细胞CD64（nCD64）、C反应蛋白（CRP）和乳酸脱氢酶（LDH）联合检测对儿童难治性肺炎支原体肺炎（RMPP）的诊断价值。方法选取肺炎支原体感染的患儿147例，根据病情和治疗情况分为RMPP组（70例）和普通肺炎支原体肺炎（GMPP）组（77例）。收集研究对象年龄、性别、入院24 h内血常规白细胞计数（WBC）、血清降钙素原（PCT）、CRP和LDH；采用流式细胞术检测患儿血液的nCD64水平；采用多因素Logistic回归分析患儿RMPP病情的影响因素；绘制受试者工作特征（ROC）曲线评估nCD64、CRP和LDH联合检测对儿童RMPP的诊断价值。结果 RMPP组住院时间长于GMPP组（P<0.05）。RMPP组患儿nCD64、CRP和LDH水平高于GMPP组（P<0.05），WBC和PCT差异无统计学意义。多因素Logistic回归分析显示nCD64、CRP和LDH升高是儿童RMPP的危险因素（P<0.05）；ROC曲线显示nCD64、CRP和LDH诊断儿童RMPP的曲线下面积（AUC）分别为0.817、0.863和0.805，三个指标联合检测的AUC为0.948。结论 RMPP患儿血液中nCD64、CRP和LDH水平较GMPP患儿升高，三指标联合检测对儿童肺炎支原体肺炎中的RMPP具有较高的诊断价值。

关键词: 肺炎, 支原体, 难治病, C反应蛋白质, 中性粒细胞CD64, 乳酸脱氢酶

Abstract:

Objective To investigate the value of the combined detection of neutrophil CD64 (nCD64), C-reactive protein (CRP) and lactate dehydrogenase (LDH) in the diagnosis of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children. Methods A total of 147 children with Mycoplasma pneumoniae infection were enrolled and divided into the RMPP group (n = 70) and the general Mycoplasma pneumoniae pneumonia group (GMPP, n = 77) based on disease severity and treatment response. The age, gender, white blood cell count (WBC) within 24 hours of admission, serum procalcitonin (PCT), C-reactive protein (CRP) and lactate dehydrogenase (LDH) levels were collected in the study participants. The expression level of nCD64 in peripheral blood was measured using flow cytometry. Multivariate Logistic regression analysis was conducted to identify the independent risk factors associated with RMPP in children. Additionally, a receiver operating characteristic (ROC) curve was constructed to assess the diagnostic performance of the combined detection of nCD64, CRP and LDH for RMPP in children. Results The RMPP group had a longer hospital stay than the GMPP group (P<0.05). Levels of nCD64, CRP and LDH were significantly higher in the RMPP group compared to those of the GMPP group (P<0.05), and there were no significant differences in WBC and PCT levels between the two groups. Multivariate Logistic regression analysis showed that elevated nCD64, CRP and LDH were risk factors for RMPP in children (P<0.05). ROC curve analysis revealed that the areas under the curve (AUC) for nCD64, CRP and LDH in diagnosing RMPP were 0.817, 0.863 and 0.805, respectively. The combined detection of three indicators for AUC was 0.948. Conclusion The levels of nCD64, CRP and LDH in blood of children with RMPP are higher than those of children with GMPP. The combined detection of the three indicators has a high diagnostic value for RMPP in children with Mycoplasma pneumoniae pneumonia.

Key words: pneumonia, mycoplasma, refractory diseases, C-reactive protein, neutrophil CD64, lactate dehydrogenase

中图分类号:

R725.6

图/表 5

参考文献 21

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组别	年龄/岁			住院时间/d	体质量/kg
GMPP组	6.71±2.60			5.84±1.45	26.00（20.30，34.00）
RMPP组	6.31±2.65			7.11±2.07	24.50（19.63，30.50）
t或Z	0.925			4.271^＊＊	1.271
组别		n	男性			身高/cm
GMPP组		77	42（54.5）			127.35±19.46
RMPP组		70	32（45.7）			123.76±19.39
χ²或t			1.144			1.120

组别	年龄/岁			住院时间/d	体质量/kg
GMPP组	6.71±2.60			5.84±1.45	26.00（20.30，34.00）
RMPP组	6.31±2.65			7.11±2.07	24.50（19.63，30.50）
t或Z	0.925			4.271^＊＊	1.271
组别		n	男性			身高/cm
GMPP组		77	42（54.5）			127.35±19.46
RMPP组		70	32（45.7）			123.76±19.39
χ²或t			1.144			1.120

组别	CRP/（mg/L）			LDH/（U/L）		PCT/（ng/L）
GMPP	6.24±4.20			230.32±33.94		0.13±0.07
RMPP	15.39±8.35			305.90±113.43		0.16±0.06
t	8.264^＊＊			5.360^＊＊		1.818
组别		n	nCD64		WBC/（×10⁹）
GMPP		77	0.74±0.53		8.42±3.13
RMPP		70	1.62±0.88		9.10±3.32
t			7.261^＊＊		1.286

组别	CRP/（mg/L）			LDH/（U/L）		PCT/（ng/L）
GMPP	6.24±4.20			230.32±33.94		0.13±0.07
RMPP	15.39±8.35			305.90±113.43		0.16±0.06
t	8.264^＊＊			5.360^＊＊		1.818
组别		n	nCD64		WBC/（×10⁹）
GMPP		77	0.74±0.53		8.42±3.13
RMPP		70	1.62±0.88		9.10±3.32
t			7.261^＊＊		1.286

变量	β	SE	Wald χ²	P	OR	OR 95%CI
nCD64	1.346	0.403	11.173	0.001	3.843	1.745~8.462
LDH	0.031	0.008	13.212	<0.001	1.031	1.014~1.048
CRP	0.313	0.067	21.710	<0.001	1.368	1.199~1.560
常数项	-12.523	2.505	24.988	<0.001	0.000

nCD64、CRP联合LDH对儿童难治性肺炎支原体肺炎的诊断价值

Diagnostic value of the combination of serum neutrophil CD64, CRP and LDH in children with refractory Mycoplasma pneumoniae pneumonia

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变量	AUC	95%CI	截断值	约登指数	敏感度/ %	特异度/ %
nCD64	0.817	0.746~0.889	0.10	0.543	68.6	85.7
LDH	0.805	0.734~0.875	252.00 U/L	0.482	72.9	75.3
CRP	0.863	0.807~0.920	5.36 mg/L	0.558	100.0	55.8
指标联合	0.948	0.915~0.981		0.792	85.7	93.5

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