Volume 29, Issue 5, 2020


DOI: 10.24205/03276716.2020.1119

Significance of Lactate Dehydrogenase to Diagnosis and Treatment of Refractory Mycoplasma Pneumoniae Pneumonia


Abstract
Objective: To explore the significance of lactate dehydrogenase (LDH) to the diagnosis and treatment of refractory Mycoplasma pneumoniae pneumonia (RMPP). Methods: A total of 70 children with RMPP (RMPP group) and another 70 children with non-refractory MPP (MPP group) who were treated in our hospital from January 2017 to January 2020 were enrolled using the propensity score matching method. According to the therapeutic effect of RMPP, the children in RMPP group were divided into effective group and ineffective group. The value of serum LDH level before treatment for diagnosing RMPP and predicting the therapeutic effect of RMPP was analyzed. Results: The febrile course was longer, and the neutrophil ratio (N), white blood cell count (WBC), levels of C-reactive protein (CRP) and LDH and the proportions of cases of cough, gasping, double pneumonia, skin lesion and short breath were higher in RMPP group than those in MPP group (P<0.05). Upon admission, the course of disease and febrile course were longer, and the N, levels of CRP and LDH and the proportion of involvement of >2 lobes were higher in ineffective group than those in effective group (P<0.05). Multivariate logistic regression analysis revealed that LDH, febrile course and double pneumonia were related factors for the occurrence of RMPP (P<0.05). LDH and involvement of >2 lobes were the factors influencing the therapeutic effect of RMPP (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of LDH in diagnosing RMPP was 0.81, and the specificity and sensitivity were 71.2% and 85.1%, respectively. AUC of LDH in predicting the therapeutic effect of RMPP was 0.75, and the specificity and sensitivity were 64.2% and 78.1%, respectively. Conclusion: LDH is an independent factor affecting the occurrence and therapeutic effect of RMPP. The LDH level in peripheral blood has a certain value for diagnosing RMPP and predicting the prognosis of RMPP.

Keywords
refractory Mycoplasma pneumoniae pneumonia; lactate dehydrogenase; diagnosis; treatment; biomarker

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