肺炎支原体肺炎患儿发生心血管系统损害的危险因素分析

Risk Factors of Cardiovascular System Damage in Children with Mycoplasma Pneumoniae

目的:探讨肺炎支原体肺炎(MPP)患儿并发心血管系统损害的危险因素。方法:选取我院收治的241例MPP患儿为研究对象,收集患儿入院时的一般临床资料及实验室检查指标,按照是否并发心血管系统损害将患儿分为两组:心血管损害组和非心血管损害组,比较两组相关指标的差异,并对相关危险因素进行Logistic回归分析。结果:241例MPP患儿中有51例发生心血管系统损害(发生率21.2%);单因素分析提示:两组在年龄、急性期MP-Ab、胸腔积液、热程、血沉(ESR)、血清C反应蛋白(CRP)、白细胞计数(WBC)、血清CD4+/CD8+比值、发病7 d内应用大环内酯类药物、发病10 d内用药糖皮质激素存在统计学差异(P<0.05);二分类非条件Logistic回归分析提示:年龄、热程、胸腔积液、CRP是MPP患儿发生心血管系统损害的独立危险因素(P<0.05);血清CD4+/CD8+比值、发病7 d内应用大环内酯类药物则为保护性因素。结论:年龄、热程、胸腔积液、CRP是MPP患儿发生心血管系统损害的独立危险因素,而早期应用大环内酯类药物、及高CD4+/CD8+比值则为保护性因素,应当引起临床注意。

Objective： To investigate the related risk factors for cardiovascular system damage in children with mycoplasma pneumoniae pneumonia （MPP）. Methods： Selected 241 cases of children MPP in our hospital as the research objects, collected their general clinical data and laboratory examination indexes on admission. Then according to whether the patients complicated with cardiovascular system damage, they were divided into two groups： cardiovascular damage group and cardiovascular normal group. Compare the difference of related indicators between two groups, and analyze the related risk factors by logistic regression method. Results： A total of 51 cases of MPP children had cardiovascular system damage （an incidence of 21.2%）. Single factor analysis indicated that there were statistical differences between the two groups in age, acute phase MP-Ab, pleural effusion, heat, blood sedimentation （ESR）, serum C-reactive protein （CRP）, white blood cell count （WBC）, ratio of serum CD4^＋/CD8^＋, macrolides used within 7 d and glucocorticoid used within 10 d （P〈0.05）. Binary classification unconditioned Logistic regression analysis showed that the age, thermal process, pleural effusion and CRP were independent risk factors for MPP children with cardiovascular system damage （P〈0.05）, while ratio of serum levels CD4^＋/CD8^＋, macrolides used within 7 d were protective factors. Conclusion： The independent risk factors for MPP children with cardiovascular system damage include age, thermal process, pleural effusion and CRP, and protective factors include early application ofmacrolides drugs and high ratio of CD4^＋/CD8^＋. Clinical attention should be paid to these factors.