The significance of lactate dehydrogenase in the diagnosis and treatment of children with refractory Mycoplasma pneumoniae pneumonia / 中国小儿急救医学

ABSTRACT

Objective To investigate the significance of lactate dehydrogenase(LDH) in the diagnosis and treatment of children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods This was a study of children with Mycoplasma pneumoniae pneumonia(MPP) admitted to hospital from June 2013 to June 2016.All patients were treated with erythromycin.Based on the definition of RMPP,subjects were divided into usual MPP group and RMPP group.The children in RMPP group were treated with erythromycin combined with methylprednisolone.The indicators including LDH,WBC counts,C-reactive protein,erythrocyte sedimentation rate(ESR),alanine aminotransferase(ALT),aspartate amino ransferase(AST) and creatine kinase were analyzed between RMPP group and usual MPP group.The differences of the above indicators between the effective and ineffective group before and after methylprednisolone treatment were also compared.Results In total,253 subjects were enrolled,including 161 in the usual MPP group and 92 in the RMPP group.The average age in RMPP group was older than that in the usual MPP group.The indicators(including LDH,AST,ALT,and ESR) of RMPP group were higher than those in the usual MPP group.Logistic regression showed that LDH and ESR were the significant factors in predicting RMPP.The odds ratio(OR) of LDH was 1.029 with 95%CI 1.020-1.037,and the OR of ESR was 1.063 with 95%CI 1.009-1.120.Receiver operating characteristic curve analysis showed that the area under the curve of LDH(400.50U/L) was the largest(0.959,95%CI 0.936-0.983).The administration of methylprednisolone to patients in the RMPP group resulted in the rapid improvement of symptoms and decrease in serum LDH and ESR levels in effective group(P＜0.05).Conclusion Serum LDH may be used as a biomarker to predict RMPP at the early stage,also may be an important marker for the evaluation of therapeutic efficacy in RMPP.