Value of lactate dehydrogenase in predicting refractory Mycoplasma pneumoniae pneumonia in children: an evaluation based on decision curve analysis and dose-response analysis / 中国当代儿科杂志

ABSTRACT

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 dose-response relationship.