儿童难治性肺炎支原体肺炎高危因素logsitic回归分析

Logistic Regression Analysis of High-risk Factors for Death on Children's Refractory Mycoplasma Pneumoniae

目的:探讨难治性肺炎支原体肺炎(RMPP)的危险因素及其临床意义。方法:回顾性分析109例肺炎支原体患儿的临床资料,比较49例难治性肺炎支原体肺炎与60例普通型支原体肺炎(MPP)临床资料的差异,并进行logsitic回归分析。结果:RMPP具有热程较长>10d,肺外并发症的发生率高,影像学改变以单侧肺部大片状实变影且累及两个肺叶以上、合并胸腔积液,尤其以右上肺病变多见,实验室检查CRP(C反应蛋白)和LDH(乳酸脱氢酶)明显增高,logsitic回归分析显示为RMPP的独立危险因素为热程较长,合并多量胸腔积液、右上肺病变多见,CRP和LDH明显增高(p均<0.05)。结论:热程>10d肺部影像学以右上肺病变多见、CRP>40mg/L和LDH>410U/L,对难治性肺炎支原体肺炎早期识别有临床意义。

Objetive： To explore the risk factors and clinical significance of refractory Mycoplasma pneumoniae pneumonia（ RMPP）. Methods： The clinical data of 109 children with Mycoplasma pneumoniae were retrospectively analyzed. The clinical data of 49 cases of refractory Mycoplasma pneumoniae pneumonia and 60 cases of Mycoplasma pneumoniae pneumonia（ MPP） were compared,and Logsitic regression analysis was performed. Results： RMPP had a long〉 10 day with a long duration of heat and high incidence of extrapulmonary complications. The imaging changed in a large area of one side of the lung,involving two lobes above the lobes,and pleural effusion,especially in the right upper lung. CRP（ C reactive protein） and LDH（ lactate dehydrogenase） were significantly higher in the laboratory. Logsitic regression analysis showed that the independent risk factor for RMPP was long heat course,multiple pleural effusion,right upper lung disease,CRP and LDH increased significantly（ P〈0. 05）. Conclusions： Thermal process is more than 10 days,mainly seen on the top of the right lung,CRP 〉40 mg/L,LDH〉410 U/L. It raises a clinical significance of distinguish early period of RMPP.