Objective: To evaluate the dynamic changes in neutrophil-to-lymphocyte ratio (NLR), interleukin-6 (IL-6), C-reactive protein (CRP), and procalcitonin (PCT) levels in children with Mycoplasma pneumoniae pneumonia (MPP) complicated by myocardial injury and to determine their predictive value both individually and in combination. Methods: 150 children diagnosed with MPP at Jiujiang Maternal and Child Health Hospital between June 2023 and June 2024 were selected. Patients were divided into the myocardial damage group (MD group, n = 65) and the non-myocardial damage group (non-MD group, n = 85), based on the presence of myocardial injury. Ninety hospitalized children without MPP served as the control group (Con group). Myocardial enzyme profile indicators, including lactate dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (α-HBDH), aspartate aminotransferase (AST), high-sensitivity cardiac troponin I (hs-cTnI), creatine kinase (CK), and creatine kinase-MB (CK-MB), were measured using a chemiluminescent immunoassay analyzer. Serum NLR, IL-6, CRP, and PCT levels were determined using appropriate analyzers. The correlation between these markers and myocardial enzyme indicators was analyzed using Spearman correlation analysis. Multivariate logistic regression was applied to identify risk factors for myocardial injury in MPP patients. Results: Serum levels of NLR, IL-6, CRP, and PCT in the MD and non-MD groups were significantly higher than in the Con group (P < 0.05), with the MD group showing higher levels than the non-MD group (P < 0.05). These markers were positively correlated with myocardial enzyme indicators. Logistic regression identified elevated NLR, IL-6, CRP, PCT, LDH, α-HBDH, AST, hs-cTnI, CK, and CK-MB as risk factors for myocardial injury in MPP patients (P < 0.05). Conclusion: Elevated levels of NLR, IL-6, CRP, PCT, and myocardial enzymes are significant risk factors for myocardial injury in children with MPP, offering valuable insights for prevention and prognosis.
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