Predictive value of combined detection of whole blood cell-derived inflammatory markers for severe mycoplasma pneumoniae pneumonia in children

ZHUO Yue; LI Hongju; WANG Lihong; LOU Junwei; YANG Jinxue

doi:10.13431/j.cnki.immunol.j.20250125

Abstract：Objective To investigate the early predictive value of whole blood cell-derived inflammatory markers for severe mycoplasma pneumoniae pneumonia(SMPP)in children.Methods In total,84 children with SMPP admitted from February 2023 to February 2025 were selected as the severe group,and 67 children with mild mycoplasma pneumoniae pneumonia(MPP)admitted during the same period were selected as the non-severe group.The monocyte-to-lymphocyte ratio(MLR),systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),systemic inflammatory response index(SIRI),and platelet-to-lymphocyte ratio(PLR)were compared between the two groups.According to the prognosis of children with SMPP,they were further divided into a good prognosis subgroup(n=40)and a poor prognosis subgroup(n=44).The differences in whole blood cell-derived inflammatory markers between the two groups were analyzed.The influencing factors of the occurrence and poor prognosis of SMPP in children were clarified through multivariate logistic regression analysis.Pearson correlation analysis was used to analyze the correlations between MLR,SII,NLR,SIRI,PLR and the poor prognosis of children with SMPP.The predictive value of various whole blood cell-derived inflammatory markers detected alone and in combination for the occurrence and prognosis of SMPP in children was evaluated by the receiver operating characteristic(ROC)curve.Results The proportions of children with lung involvement≥2/3 lobes,the incidence of large lung consolidation shadows,MLR,SII,NLR,SIRI and PLR in the severe group were all higher than those in the non-severe group(P<0.05,P<0.01).The levels of MLR,SII,NLR,SIRI and PLR in the poor prognosis subgroup were all higher than those in the good prognosis subgroup(P<0.05,P<0.01).Pearson correlation analysis showed that MLR was strongly and positively correlated with poor prognosis in children with SMPP,SII,NLR,and SIRI were moderately and positively correlated with poor prognosis in children with SMPP,and PLR was weakly and positively correlated with poor prognosis in children with SMPP(P<0.01).Multivariate logistic regression analysis showed that MLR,SII,NLR,SIRI and PLR were all independent risk factors for SMPP in children(P<0.05,P<0.01).The extent of lung involvement,MLR,SII,NLR,SIRI and PLR were all independent risk factors for poor prognosis in children with SMPP(P<0.05,P<0.01).ROC curve analysis showed that the area under the ROC curve(AUC)for MLR,SII,NLR,SIRI,and PLR detected in combination for the prediction of SMPP occurrence in children was 0.969(95%CI:0.927,0.990),with a sensitivity of 91.67%and a specificity of 89.55%,which was significantly better than the prediction of each index alone(P<0.01).The AUC of MLR,SII,NLR,SIRI and PLR detected in combination for the prognostic prediction of children with SMPP was 0.930(95%CI:0.877,0.965),with a sensitivity of 96.67%and a specificity of 85.55%,which was significantly better than the prediction of each index alone(P<0.01).Conclusion The whole blood cell-derived inflammatory markers MLR,SII,NLR,SIRI,and PLR are closely related to the occurrence,development,and poor prognosis of SMPP in children.They can be used as independent risk factors for the progression and poor prognosis of MPP,and their combined detection can improve the predictive value.