外周血WBC、NLR、CRP水平在评估小儿 肺炎支原体肺炎病情严重程度的临床价值

The Clinical Value of Peripheral Blood SAA, CRP, WBC and NLR Levels in Evaluating the Severity and Prognosis of Mycoplasma pneumoniae Pneumonia in Children

摘要: 目的：探讨外周血白细胞计数(WBC)、中性粒细胞/淋巴细胞(NLR)和C反应蛋白(CRP)与肺炎支原体肺炎(MPP)患儿病情程度及预后的关系。方法：回顾选择常德市第一中医医院2025年8月至2025年12月期间收治的126例MPP患儿作为研究对象(MPP组)，根据按照患儿病情严重程度分为轻症组95例和重症组31例，另选择同期本院健康体检儿童76人作为对照组，比较对照组和MP组的外周血WBC、NLR及CRP，比较轻症组和重症组的外周血WBC、NLR及CRP水平，采用Pearson和Spearman相关性分析外周血WBC、NLR及CRP与MPP患儿病情程度的相关性。受试者工作特征(Receiver Operating Characteristic, ROC)曲线分析外周血WBC、NLR及CRP单独及联合检测对MPP患儿病情严重程度的评估价值。结果：MPP组的外周血WBC、NLR及CRP高于对照组(P < 0.05)。重症组的外周血WBC、NLR及CRP高于轻症组(P < 0.05)。外周血WBC、NLR及CRP高于与病情程度呈正相关(P < 0.05)。外周血WBC、NLR及CRP单独检测评估MPP患儿的病情严重程度的曲线下面积(AUC)分别为0.632、0.884、0.837；外周血WBC、NLR及CRP联合检测评估MPP患儿的病情严重程度的AUC为0.918，显著高于单独检测。结论：外周血WBC、NLR及CRP水平异常升高参与MPP病情进展及不良预后。联合检测外周血WBC、NLR及CRP水平可有效评估MP患儿的短期预后。

Abstract: Objective: To explore the relationship between peripheral blood white blood cell count (WBC), neutrophil/lymphocyte (NLR), and C-reactive protein (CRP) and the severity and prognosis of children with Mycoplasma pneumoniae pneumonia (MPP). Method: A total of 126 children with MPP admitted to the First Hospital of Traditional Chinese Medicine of Changde City from August 2025 to December 2025 were selected as the research subjects (MPP group). According to the severity of the children’s conditions, they were divided into the mild group with 95 cases and the severe group with 31 cases. Additionally, 75 children who underwent healthy physical examinations in our hospital during the same period were selected as the control group. The levels of peripheral blood WBC, NLR and CRP in the control group and the MPP group were compared, and the levels of peripheral blood WBC, NLR and CRP in the mild group and the severe group were compared. Pearson and Spearman correlation analyses were used to analyze the correlations between peripheral blood WBC, NLR and CRP and the severity of the disease in children with MPP. The receiver operating characteristic (ROC) curve was used to analyze the evaluation value of peripheral blood WBC, NLR and CRP alone and in combination for the severity of the disease in children with MPP. Result: The peripheral blood WBC, NLR and CRP in the MP group were higher than those in the control group (P < 0.05). The levels of peripheral blood WBC, NLR and CRP in the severe group were higher than those in the mild group (P < 0.05). The levels of WBC, NLR and CRP in peripheral blood were positively correlated with the severity of the disease (P < 0.05). The area under the curve (AUC) for evaluating the severity of the disease in children with MPP by detecting peripheral blood WBC, NLR and CRP separately was 0.632, 0.884 and 0.837, respectively. The AUC of combined detection of peripheral blood WBC, NLR and CRP for evaluating the severity of the disease in children with MP was 0.918, which was significantly higher than that of individual detection. Conclusion: Abnormally elevated levels of WBC, NLR and CRP in peripheral blood are involved in the progression of MPP and poor prognosis. Combined detection of peripheral blood WBC, NLR and CRP levels can effectively evaluate the short-term prognosis of children with MPP.