Abstract:Objectives: To analyze the clinical characteristics of children with elevated D-dimer and the effect of low molecular weight heparin (LMWH) in children with MPP. Methods: 99 hospitalized children with Mycoplasma pneumoniae pneumonia with D-dimer elevation from May 2014 to may 2019 were randomly divided into three groups: group A, group B and group C. all the children in the three groups were given anti infection and routine symptomatic treatment. On this basis, group a combined with 100iu / kg LMWH for subcutaneous injection, and group B combined with 50iu / kg LMWH for basic treatment Group C maintained routine and anti infection treatment. Analysis of three groups of children before and after treatment chest imaging results and clinical symptoms, compared with the cost of hospitalization and hospitalization days. In addition, 33 cases of MPP without abnormal D-dimer in the same period of hospitalization were selected as the control group, and ESR and CRP and other inflammatory indexes, chest imaging results, clinical symptoms and hospitalization costs were compared between group C and control group. Results: In the control group, the inflammatory indicators such as ESR and CRP were significantly lower than those in the group C, and the hospital cost, length of stay, duration of fever reduction and cough remission of the former were significantly lower than those in the group C (all P<0.05). The majority of chest imaging findings in the control group were small films, while the majority of chest imaging findings in the group C were large films. The difference between the two groups was statistically significant (P<0.05). The hospitalization cost, length of stay, chest imaging improvement time and cough relief time of children in group a and group b were significantly lower than those in group C (all P<0.05). There was no significant difference in antipyretic time between groups A, B and C (P>0.05). In this study, all the children in each group had normal electrolyte and liver and kidney functions, and no adverse reactions such as bleeding and coagulation mechanism disorder occurred. Conclusion: In children with MPP, the symptoms and inflammatory indexes of children with abnormal D-dimer and chest imaging examination are more serious than those of normal children. Low molecular weight heparin can effectively promote the absorption of pulmonary lesions in children with MPP with elevated D-dimer, shorten the hospitalization time and reduce the cost of children, and will not increase the incidence of adverse reactions in a short period of time.
罗姣姣, 周琳, 王玉梅. D-二聚体升高MPP患儿临床特点及低分子肝素的辅助治疗效果观察[J]. 河北医学, 2020, 26(1): 126-129.
LUO Jiaojiao, et al. Clinical Characteristics of Children with MPP Increased by D-dimer and Effect of Low Molecular Weight Heparin on Adjuvant Therapy. HeBei Med, 2020, 26(1): 126-129.
[1] 张春峰,贺艺璇,吴润辉,等.低分子肝素辅助治疗D-二聚体升高的儿童重症肺炎支原体肺炎的疗效观察[J].北京医学,2019,41(3):183~186. [2] Hsu JY, Liu AB. Anticoagulants for cancer-associated ischemic stroke[J]. Ci Ji Yi Xue Za Zhi, 2019,31(3):144~148. [3] Jiang H, Meng J, Guo T, et al. Comparison of apixaban and low molecular weight Heparin in preventing deep venous thrombosis after total knee arthroplasty in older adults[J]. Yonsei Med, 2019,60(7):626~632. [4] Drozd NN, Logvinova YS, Shagdarova BT, et al. Analysis of the action of quaternized chitosans with different molecular weight on anticoagulant activity of heparins in vitro[J]. Bull Exp Biol Med, 2019,167(2):279~283. [5] 彭万胜,武玉猛,陈信,等.重症肺炎支原体肺炎早期应用糖皮质激素治疗的随机对照研究[J].蚌埠医学院学报,2017,42(4):431~433. [6] 颜珲,覃广萍,万芳.超小剂量肝素钠联合肺部超短波理疗治疗小儿肺炎的临床疗效观察[J].医学信息,2015,(34):303. [7] Ourri B, Francoia JP, Monard G, et al. Dendrigraft of poly-l-lysine as a promising candidate to reverse heparin-based anticoagulants in clinical settings[J]. ACS Med Chem Lett, 2019,10(6):917~922. [8] 朱影,王婧.儿童难治性肺炎支原体肺炎高危因素logsitic回归分析[J].河北医学,2018,24(5):760~763. [9] Drozd NN, Logvinova YS, Shagdarova BT, et al. Analysis of the action of quaternized chitosans with different molecular weight on anticoagulant activity of heparins In vitro[J]. Bull Exp Biol Med, 2019,167(2):279~283.