Correlation strength of procalcitonin clearance with severity and prognosis of Mycoplasma pneumoniae pneumonia in children

WU Rui; SHU Li

doi:10.3969/j.issn.1007-8134.2023.05.006

Abstract：Objective To explore the predictive value of procalcitonin clearance rate(PCTs)on the severity and prognosis of Mycoplasma pneumoniae pneumonia(MPP)in children.Method A total of 138 children with MPP admitted to our hospital from February 2021 to March 2022 were selected as the study objects.According to the efficacy evaluation,the children were divided into an ineffective group(65 cases)and an effective group(73 cases).Multivariate Logistic regression was used to increase the analysis of independent influencing factors of poor prognosis in children,The relationship between PCTs and mycoplasma pneumoniae pneumonia in children was analyzed with restricted cubic spline.The predictive value of PCTs for MPP adverse events was evaluated.Results Among 138 children with MPP,the incidence of ineffectiveness was 47.10％(65/138).WBC,CRP,D-dimer,ALT,total bilirubin,creatinine and FIB in the ineffective group were significantly higher than those in the effective group,and PCTs were lower than those in the effective group,with statistical significance(P＜0.05).There was no significant difference in gender,age and BMI between the 2 groups(P＞0.05).To develop a predictive model to evaluate the prognostic risk of mycoplasma pneumoniae pneumonia in children,That is,multivariate Logistic regression model =0.026×WBC(×109/L)+0.125×CRP(mg/L)+0.256×D-dimer(mg/L)-0.351×PCTs(％)+0.335×ALT(U/L)+0.108×total bilirubin(μmol/L)+0.614×creatinine(μmol/L)+0.185×FIB(g/L).In ROC analysis of the prediction model,AUC was 0.869(95％CI:0.812～0.901),sensitivity was 85.62％,specificity was 89.67％,and Yoden index was 0.756.All patients were grouped according to the median PCTs of 16.23％,with PCTs≥16.23％considered normal and PCTs＜16.23％considered abnormal.The results showed that compared with the effective group,the proportion of abnormal PCTs in the ineffective group was higher(P＜0.05).The curve between PCTs level and the probability of mycoplasma pneumoniae pneumonia in children was plotted by univariate Logistic regression.With the increase of PCTs level,the probability of mycoplasma pneumoniae pneumonia in children gradually decreased.When the high-risk threshold was(1％-70％),the net benefit rate was＞0,which had clinical significance.The smaller the high-risk threshold is between 1％and 70％,the higher the net benefit rate and the greater the clinical significance.Conclusions Early review of PCTs can predict the disease severity and improved prognosis of MPP children in a more timely manner,which has certain clinical reference value.