Value Of Lactate Dehydrogenase In Predicting Refractory Mycoplasma Pneumoniae Pneumonia In Children:An Evaluation Based On Decision Curve Analysis And Dose-response Analysis

Objective: To study the value of lactate dehydrogenase(LDH)in predicting refractory Mycoplasma pneumoniae pneumonia(RMPP)in children.Methods: Propensity score matching was used to select 73 children with RMPP(refractory group)and 146 children with non-refractory Mycoplasma pneumoniae pneumonia(common group).The logistic regression analysis,restricted cubic spline model,and decision curve analysis were used to analyze the clinical value of LDH in predicting RMPP.Results: There were significant differences in the incidence of high fever,white blood cell count,platelet count,percentage of neutrophils,and serum levels of C-reactive protein,procalcitonin,hemoglobin,albumin,glutamic-pyruvic transaminase,aspartate aminotransferase and LDH(P<0.05).There were also significant differences between the two groups in the Mycoplasma pneumoniae-DNA load in nasopharyngeal aspirates and the incidences of pleural effusion,pulmonary consolidation,atelectasis,shortness of breath and skin lesions(P<0.05).The multivariate logistic regression analysis showed that high fever,hemoglobin level,LDH level,and pulmonary consolidation were independent predictive factors for RMPP(OR=10.097,0.956,1.006,and 3.756;P<0.05).The results of the restricted cubic spline analysis showed a non-linear dose-response relationship between the continuous changes of LDH and the development of RMPP(P<0.01).The decision curve analysis showed that LDH had an important clinical value in predicting RMPP.Conclusions: LDH is an independent predictive factor for the development of RMPP and its intensity of association with the development of RMPP exhibits a non-linear doseresponse relationship.