| Objective: To investigate the risk factors of D-dimer increae levels in children with Mycoplasma pneumoniae pneumonia(MPP),and to analyze its clinical characteristics,so as to facilitate the timely detection of D-dimer increase in children,take effective measures for anticoagulant treatment,so as to shorten the course of disease,reduce the incidence of complications and improve the prognosis.Methods:A total of 139 children with MPP hospitalized in the Department of Pediatrics of the First Hospital of Hebei Medical University from July 2018 to August 2022 were selected.According to the plasma D-dimer level,83 children with increased D-dimer were selected as the study group,and 56 children with normal D-dimer value were selected as the control group.General data of all subjects were recorded,including.(1)clinical data: gender,age,season,whether or not the out-of-hospital treatment was standardized,duration of fever,degree of fever,degree of cough,and volume of lung.(2)Laboratory data: mainly including WBC,NEUR,CRP,ESR,HB,PLT and some biochemical indicators ALT,AST,CK-MB,Scr,LDH,BUN,etc;(3)Lung imaging data.SPSS26.0software was used for statistical analysis of clinical data.Risk factors of children with D-dimer increased MPP were analyzed.Some cases of the study group were treated with anticoagulation intervention and its efficacy was analyzed.Results:1.Comparison of general data between CG group and RG groupThe number of cases of body temperature>39℃,duration of fever and multiple cases of lung volume in the study group were significantly higher than those in the control group,the difference was statistically significant(P<0.05).There were no significant differences in gender,age,onset season,cough degree,and standard treatment outside the hospital between the two groups(P>0.05).2.Comparison of laboratory data between CG group and RG groupThe platelet count of RG group was significantly lower than that of CG group,while the values of CRP,ESR and LDH were significantly higher than those of control group,with statistical significance(P<0.05).There was no significant difference among WBC,NEUR,HB,CK-MB,ALT,AST,BUN and Scr2 groups(P>0.05).3.Comparison of imaging data between CG group and RG groupThe number of cases of lung consolidation or atelectasis in the study group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the number of cases of interstitial pneumonia and small spot shadow(P>0.05).4.Analysis of high risk factors in children with D-dimer increased RG groupThe results of Logistics regression analysis showed that PLT,CRP,LDH,fever degree and duration,and lung consolidation or atelectasis on imaging were independent risk factors for RG group5.The anticoagulant intervention effect of RG groupThe duration of cough,the disappearance time of pulmonary rale,the decrease amplitude of D-dimer,the time of obvious improvement of chest image,the number of cases of bronchoscopy lavage and the number of hypercoagulationrelated complications were significantly lower than or less than that of the nonanticoagulant group,and the difference was statistically significant(P<0.05).There were no significant differences in fever duration,CRP recovery time and oxygen uptake rate(P>0.05).Conclusion:1.Children with RG group are more likely to have high fever,fever duration is longer,and lung rales are more.Imaging results showed more lung consolidation or atelectasis;PLT was lower,while CRP,ESR,and LDH values were higher.2.PLT,CRP,LDH,high fever and duration,and lung consolidation or atelectasis may be independent risk factors for RG group.3.In RG group,heparin calcium anticoagulant intervention has a definite effect,which can significantly reduce the duration of cough,the disappearance time of pulmonary rura,the amplitude of D-D decline,the normal or obvious improvement time of chest image,and reduce the incidence of thrombosis and the possibility of bronchoscopy lavage. |
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