小儿肺炎支原体感染的临床特点及其危险因素分析

Analysis of clinical features and risk factors of children pneumonia infected with mycoplasma pneumoniae

目的总结分析小儿肺炎支原体感染的临床特点,探讨研究影响其的相关危险因素。方法选取2010年6月～2012年1月潍坊医学院附属青岛市胶州中心医院收治的肺炎支原体感染患儿140例为研究对象,观察记录其临床特点,并应用Logistic单因素和多因素非条件回归方程分析与其相关的独立危险因素。结果小儿肺炎支原体感染易引起支气管肺炎、支气管炎;临床主要表现为不规则型高热,热程1～7 d,咳嗽多为阵发性连声咳,胸片检查以小斑点状模糊影多见,实验室检查中以CK-MB升高为主。抗生素应用时间、季节、年龄、低补体状态和流行接触史是小儿肺炎支原体感染相关的独立危险因素,其OR 95%CI分别为1.327～5.012(P=0.013)、1.002～4.587(P=0.031)、1.330～5.912(P=0.023)、0.987～6.712(P=0.034)、0.300～7.117(P=0.028)。结论在秋冬季节出现的、阵发性连声咳、高热或超高热、免疫力低下且具有支原体流行期接触史的小儿应高度怀疑肺炎支原体感染,尽早确诊并给予及时治疗。

Objective To investigate and analyze the clinical features and the risk factors of the children with mycoplasma pneumoniae infection.Methods 140 cases of children mycoplasma pneumoniae infection in the Jiaozhou Central Hospital of Qingdao City Affiliated to Weifang Medical College from June 2010 to January 2012 were chosen for the study.The clinical features of the objects were observed and recorded.Logistic univariate analysis and multivariate analysis were used for investigating the independent risk factors.Results Bronchial pneumonia and bronchitis were very common in children mycoplasma pneumoniae infection.Irregular fever,mading a fever from 1 to 7 days,and paroxysmal cough repeatedly were the major clinical manifestations.Small punctate opacities was common in chest radiography.Elevated CK-MB was the primarily laboratory test.Antibiotic application time,season,age,low complement state and popular history of exposure were independent risk factors in children with mycoplasma pneumoniae.OR 95％Clwere 1.327-5.012 （P=0.013）,1.002-4.587 （P=0.031）,1.330-5.912 （P=0.023）,0.987-6.712 （P=0.034）,0.300-7.117 （P =0.028） respectively.Conclusion It is right to suspect mycoplasma pneumoniae infection if the children have paroxysmal repeatedly cough,fever or ultra-high fever,hypoimmunity,history of exposure,it is right to diagnose and treate promptly.