肺炎支原体感染合并不完全川崎病的危险因素分析

Risk factors of Mycoplasma pneumonia infection with incomplete Kawasaki disease

目的分析肺炎支原体感染合并不完全川崎病的危险因素。方法选取2015年1月-2018年12月福建省妇幼保健院儿科收治符合肺炎支原体感染合并不完全川崎病诊断标准的有68例,选取同时期普通病房临床资料完整符合肺炎支原体感染无合并川崎病的病例136例作为对照组,采用单因素分析和多因素二分类Logistic回归分析的方法分析肺炎支原体感染合并不完全川崎病的危险因素,并对二分类Logistic回归分析有统计学意义的相关指标进行ROC曲线分析。结果血红蛋白、白蛋白是保护性因素,发热持续时间>7天、混合2种以上病原感染、血小板计数是肺炎支原体感染合并不完全川崎病危险因素;ROC曲线临界值分别为血红蛋白<101 g/L(AUC=0.869,95%CI=0.814-0.912)、血小板计数>403×10^9/L(AUC=0.840,95%CI 0.783-0.888)、白蛋白<40.5 g/L(AUC=0.830,95%CI 0.772-0.879)、发热时间>7天(AUC=0.761,95%CI 0.696-0.818)、混合2种以上病原感染(AUC=0.551,95%CI 0.480-0.621)。结论降低的血红蛋白和白蛋白、升高的血小板计数、发热持续时间>7天、混合2种以上病原感染是肺炎支原体感染合并不完全川崎病的危险因素。

Objective To investigate the high risk factors of Mycoplasma pneumonia infection with incomplete Kawasaki disease.Methods A total of 68patients having M.pneumonia infection with incomplete Kawasaki disease were collected from January 2015 to December 2018.At the same time,a total of 136 patients having M.pneumonia infection without Kawasaki disease were selected as a control group.The risk factors of M.pneumonia infection with incomplete Kawasaki disease were analyzed by univariate and multivariate binary logistic regression analysis,and the ROC curve analysis was carried out for relevant indicators with statistical significance in binary Logistic regression analysis.Results Binary logistic regression analysis showed hemoglobin and albumin were protective factors,and the fever duration>7 d.The mixed infection of two or more pathogensand platelet countwere high risk factors of M.pneumonia infection with incomplete Kawasaki disease.The ROC curve analysis showed that the cut-off values of the 5 predictors were hemoglobin<101 g/L,area under curve(AUC=0.869,95%CI 0.814-0.912,platelet count>403×10^9/L(AUC=0.840,95%CI 0.783-0.888),albumin<40.5 g/L(AUC=0.830,95%CI 0.772-0.879),fever duration>7 d(AUC=0.761,95%CI 0.696-0.818),and the mixed infection of two or more pathogens(AUC=0.551,95%CI 0.480-0.621).Conclusion The reduced hemoglobin and albumin,increased platelet count,fever duration>7 d and mixed infection of two or more pathogens are risk factors for M.pneumonia infection with incomplete Kawasaki disease.