Journal Article

Clinical significance of D-dimer levels in refractory Mycoplasma pneumoniae pneumonia

Zhao, Deyu, Huang, Xia, Li, Dan, Liu, Feng, Tang, Heng, Zhu, Yifan

2021

Overview

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.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adenoviruses / Age / Alanine / Alanine transaminase / Alanine Transaminase - blood / Antibiotics / Aspartate aminotransferase / Aspartate Aminotransferases - blood / Blood / Blood proteins / Blood Sedimentation / Bronchoscopy / C-reactive protein / C-Reactive Protein - analysis / Child / Child, Preschool / Clinical significance / Coronaviruses / Correlation analysis / COVID-19 / D-dimer / Development and progression / Diagnosis / Dimers / Disease / Electrocardiography / Erythrocyte sedimentation rate / Erythrocytes / Female / Fever / Fibrin Fibrinogen Degradation Products - analysis / Health aspects / Healthcare-associated infection control / Hospitalization / Humans / Infections / Infectious Diseases / Inflammation / Inflammatory response / Influenza / Internal Medicine / L-Lactate dehydrogenase / L-Lactate Dehydrogenase - blood / Lactate dehydrogenase / Lactic acid / Leukocyte Count / Leukocytes / Leukocytes (neutrophilic) / Liver / Logistic Models / Male / Measurement / Medical Microbiology / Medicine / Medicine & Public Health / Multivariate analysis / Mycoplasma pneumoniae / Mycoplasma pneumoniae - genetics / Mycoplasma pneumoniae - isolation & purification / Neutrophils - pathology / Parasitology / Pathogenesis / Pleural effusion / Pleural Effusion - etiology / Pneumonia / Pneumonia in children / Pneumonia, Mycoplasma - blood / Pneumonia, Mycoplasma - complications / Pneumonia, Mycoplasma - diagnosis / Pneumonia, Mycoplasma - microbiology / Refractory Mycoplasma pneumoniae pneumonia / Regression analysis / Research Article / Retrospective Studies / Risk analysis / Risk Factors / Transaminase / Tropical Medicine / Tuberculosis / Viruses