小儿支原体肺炎肺外器官损害危险因素分析

Analysis of risk factors of extrapulmonary organ damage in children with mycoplasma pneumonia

目的:分析小儿支原体肺炎肺外器官损害相关危险因素。方法:对我院2011年1月至2013年3月收治的支原体肺炎患儿262例进行回顾性分析,分析肺外器官损害的临床特征,并将肺外器官感染的患儿作为研究组,无肺外器官感染的患儿作为对照组,分析小儿支原体肺炎肺外器官损害的危险因素。结果:①262例患儿中肺外器官受损的113例,占43.1%。其中消化系统受累57例,占50.4%;泌尿系统受累38例,占33.6%;心血管系统受累25例,占22.1%;血液系统受累22例,占19.5%;神经系统受累7例,占6.2%,皮肤黏膜肌肉关节受累5例,占4.4%。2个脏器受累患儿22例,占19.5%;3个以上脏器受累8例,占7.1%;②研究组热程≥10 d、中等至大量胸腔积液、右上叶病变、肺部大片状阴影所占比例明显高于对照组(P<0.05),发病7 d内应用大环内酯类抗生素治疗、发病10 d内应用糖皮质激素治疗比例明显低于对照组(P<0.05);③Logistic回归分析显示,研究组热程≥10 d、中至大量胸腔积液、肺部大片状阴影是支原体肺炎肺外器官受损的危险因素(P<0.05)。结论:小儿支原体肺炎易发生肺外器官损害,其中热程≥10 d、中至大量胸腔积液、肺部大片状阴影患儿易发生肺外器官损害,临床上应予以重视。

Objective： To analyze the risk factors of extrapulmonary organ damage in children with mycoplasma pneumonia. Methods： 262 children with mycoplasma pneumonia from January 2011 to March 2011 in our hospital divided into study group （children with extrapulmonary organ damag without extrapulmonary organ infection）. The risk factors of extrapulmonary organ e） and control damage were group（children retrospectively analyzed. Results： （~ The extrapulmonary organ damage occurred in 113 cases （43.1%）, including digestive system 57 cases （50.4%）, urinary tract 38 cases （33.6%）, cardiovascular system involved 25 cases （22.1%） and blood system 22 cases（19.5%）, nervous system 7 cases （6.2%）, and skin, mucous membrane muscle or joints 5 cases, （4.4%）. bi-organ affection 22 cases（19.5% ）, multi-organ affection 8 cases （7.1%）. （~ The incidence of fever over rod,moderate or large amount of pleural effusion, large patch of shadow, and right upper lobe lesions, is significantly high, and the proportion of early application of macrolide antibiotics and glucocorticoids is significantly lower than the control group （P 〈 0.05）. （~） Logistic regression analysis showed that fever over 10 d, large amount of pleural effusion and large patch of shadow were the risk factors of extrapulmonary organ damage in children with mycoplasma pneumonia （P 〈 0.05）. Conclusion： Children with mycoplasma pneumonia are easy to have extrapulmonary organ damage, when they have long duration of a large pleural effusion, and large pulmonary flake shadow. Clinical doctors should attach importance to it.