PM2.5与儿童支原体性肺炎严重程度的相关研究

Correlation between PM2.5 and severity of mycoplasma pneumonia in children

目的:探讨PM2.5与儿童不同程度支原体性肺炎的相关关系。方法:选取2016年10月至2017年1月我院收治的122例不同程度支原体性肺炎患儿,分为普通组(40例)、实变组(40例)、难治组(42例)。分析各组炎性指标(白细胞、中性粒细胞比例、C反应蛋白、降钙素原)及血小板、乳酸脱氢酶、PM2.5的差异;PM2.5与各指标间的相关性分析,进行多元Logistic回归分析及ROC曲线下面积(AUC)分析。结果:(1)普通组和实变组、难治组C反应蛋白比较差异均有统计学意义(P<0.05);实变组和难治组C反应蛋白比较差异均有统计学意义(P<0.05);普通组和难治组降钙素原比较差异有统计学意义(P<0.05);(2)难治组与普通组、实变组乳酸脱氢酶、血小板、PM2.5差异均有统计学意义(P<0.01);(3)PM2.5与C反应蛋白、乳酸脱氢酶、血小板呈正相关,r值分别为0.483、0.273、0.238(P<0.01)。(4)多元Logistic回归分析结果显示C反应蛋白、乳酸脱氢酶、血小板、PM2.5为疾病严重程度的预测因素(P<0.05)。(5)ROC曲线分析表明,C反应蛋白的AUC最大,为0.820(95%CI:0.745~0.895),PM2.5的AUC为0.810(95%CI:0.715~0.904)(P<0.01)。结论:暴露于较高浓度水平的PM2.5,儿童支原体性肺炎的严重程度可能随之上升。

Objective: To explore the correlation between PM2.5 and the severity of mycoplasma pneumonia in children. Methods: A total of 122 children with different severity of mycoplasma pneumonia from Oct 2016 to Jan 2017 were included in this study, including general group (40 cases), consolidation group (40 cases) and refractory group (42 cases). The differences in inflammatory indicators (white blood cells, neutrophil ratio, C-reactive protein, procalcitonin), platelet, lactate dehydrogenase and PM2.5 in each group were analyzed. Correlation analysis between PM2.5 and each index was conducted, multivariate logistic regression analysis and area under curve (AUC) analysis were conducted. Results:(1)The difference of C-reactive protein in each group was statistically significant (P<0.05).There was significant difference in procalcitonin in general group and refractory group(P<0.05).(2)There was significant differences in lactate dehydrogenase, platelet and PM2.5 in refractory group and general group, consolidation group (P< 0.01).(3)PM2.5 was positively correlated with C-reactive protein, lactate dehydrogenase and platelet(r value was 0.483,0.273,0.238 respectively)(P<0.05).(4)Multivariate logistic regression analysis showed that C-reactive protein, lactate dehydrogenase, platelet, and PM2.5 were the predictors of disease severity(P<0.05).(5) ROC curve analysis showed that the AUC of C-reactive protein and PM2.5 was 0.820(95%CI: 0.745-0.895) and 0.810(95%CI: 0.715-0.904)(P<0.01). Conclusion: The severity of mycoplasma pneumonia in children may increase with exposure to higher levels of PM2.5.