摘要
Abstract
Objective:To investigate the diagnostic value of computed tomography(CT)combined with TaqMan probe for cardiopulmonary injury of pediatric patients with mycoplasma pneumonia of different clinical features.Methods:The medical records of 80 pediatric patients with mycoplasma pneumonia admitted to Shijiazhuang Maternal and Child Health Care Hospital from March 2020 to March 2023 were collected,and they were divided into<1 year old group(29 cases),1-3 years old group(23 cases)and>3 years old group(28 cases).They also were divided into long disease course group(43 cases,the disease course>7 d)and short disease course group(37 cases,the disease course≤7 d).All of pediatric patients underwent CT combined with TaqMan probe method to detect the cardiopulmonary injury,and to analyze the incidences of cardiopulmonary injury in pediatric patients of different age groups and different disease course groups.The CT and TaqMan probe were adopted to detect the pleural effusion,myocardial thickness,cardiothoracic ratio and the expression level of mycoplasma nucleic acid,and receiver operating characteristic(ROC)curves were adopted to analyze the diagnostic value of CT and probe in detecting cardiopulmonary injury of patients with mycoplasma pneumonia.Results:CT imaging showed that typical pulmonary abnormalities were present in patients of 62.5%,with a diagnostic accuracy of 93.75%(75/80),which main findings were pulmonary ground glass nodules(GGO),combined bacterial pneumonia and reticulation.Bronchiectasis was found in a small portion of patients.Bilateral pulmonary involvement was found in patients with pulmonary abnormalities,and the involvement of lower lobe was the most obvious in them.The 38 pediatric patients with clinically suspected incidental pulmonary embolism(PE)received additional CT examination with contrast agent,and the 24 pediatric patients of them were diagnosed as PE,and the diagnostic accuracy was 63.15%(24/38).TaqMan probe method was adopted to detect mycoplasma infection,and a high sensitivity and wide dynamic range detection system was established,which could conduct six times of dilutions for 10-fold between 0.2-0.2×10-5.Preparation was performed in 1 ng/μ l microbial community(MMC)-DNA standards,which had high linear dynamic range of 6 times of log10 dilutions with regression coefficient of R2=1.The detection lower limit was found to be 2×10-15 g/μl DNA.The incidence of cardiopulmonary injury gradually decreased with increasing age of pediatric patients with mycoplasma pneumonia of different ages.The incidences of cardiopulmonary injury in pediatric patients with mycoplasma pneumonia of<1 year old group,1 to 3 years old group and>3 years old group were respectively 93.10%,73.91%and 21.43%,and there were significant differences among the 3 groups(x2=7.660,33.019,P<0.05).The incidence(93.02%)of cardiopulmonary injury of long disease course group was significantly higher than that of short disease course group(27.03%),and the differences were statistically significant(x2=12.070,36.960,P<0.05),respectively.The amount of pleural effusion in the cardiopulmonary injury group was significantly higher than that in the non-cardiopulmonary damage group,and the myocardial thickness of cardiopulmonary injury group was significantly increased at the same time,and the cardiothoracic ratio of cardiopulmonary injury group was also significantly higher than that of non-cardiopulmonary injury group.There was significant difference in the expression level of mycoplasma nucleic acid(t=9.52,3.33,4.22,10.00,P<0.05).ROC curve analysis showed that the AUC value of CT combined with TaqMan probe method was larger than 0.5 in diagnosing cardiopulmonary injury of pediatric patients with mycoplasma pneumonia of different clinical features,and the AUC value of the combined diagnosis was largest.Conclusion:CT combined with TaqMan probe method has higher diagnostic value for the cardiopulmonary injury of pediatric patients with mycoplasma pneumonia.It should be considered to conduct the diagnosis of cardiopulmonary injury for pediatric patients who persistently exist the clinical symptom of mycoplasma pneumonia.The adaptation of existing TaqMan probe method,and the further expanded dPCR detection combination would improve the microbial diagnostic toolbox,which would provide reliable quantitative data for treatment decisions to cardiopulmonary injury of pediatric patients with mycoplasma pneumonia.关键词
计算机断层成像(CT)/TaqMan探针法/支原体肺炎/心肺损害Key words
Computed tomography(CT)/TaqMan probe method/Mycoplasma pneumonia/Cardiopulmonary injury分类
医药卫生
