儿童复杂性肺炎旁胸腔积液危险因素分析

Analysis of risk factors for complicated parapneumonic effusion in children

目的探讨儿童复杂性肺炎旁胸腔积液(CPPE)发生的相关危险因素。方法回顾性分析2013年1月至2015年4月因肺炎旁胸腔积液住院的88例患儿的临床资料,根据应用抗生素治疗是否有效及相关文献分为复杂性肺炎旁胸腔积液组(CPPE组)及非复杂性肺炎旁胸腔积液(UPPE)组;对两组患儿的临床和实验室指标进行组间单因素分析,并进一步行多因素logistic回归分析,绘制受试者工作特征(ROC)曲线。结果单因素分析结果显示,两组患儿在纤维分隔形成及血清CD3^+、CD19^+水平的差异有统计学意义(Z=2.030~7.457,P均<0.05);多因素logistic回归分析显示,纤维分隔形成及CD19^+为CPPE发生的独立危险因素(OR=3.386~4.000,P<0.05);logistic回归模型的ROC曲线下面积(AUC)=0.707,具有中等诊断准确度(P=0.001)。结论伴有纤维分隔形成及血清CD19^+含量>30%的PPE患儿发展为CPPE的可能性大。

Objective To investigate the related risk factors of complicated parapneumonic effusion（CPPE） in children.Method The clinical data of 88 children with parapneumonic effusion（PPE） were retrospectively analyzed from January 2013 to April 2015.According to the treatment effect of antibiotics,CPPE group and uncomplicated parapneumonic effusion（UPPE） group were divided.The univariate analysis of clinical and laboratory parameters was performed between two groups.Then the multifactor logistic regression was performed further.The receiver operator characteristic（ROC） curve was draw.ResultsThe univariate analysis indicated that the risk factors were the formation of loculation and serum CD3-＋ and CD19-＋ levels（Z=2.030-7.457,P〈0.05）.The multifactor logistic regression showed that the formation of loculation（OR=3.386,P=0.018）and serum CD19-＋ levels（OR=4.000,P=0.009）were independent risk factors of CPPE.The area under the ROC curve（AUC） is 0.707,which indicated that the regression model had medium diagnostic accuracy（P=0.001）.Conclusion CPPE may be developed in PPE children with the serum level of CD19-＋ 30% and the formation of loculation.