MPP合并胸腔积液患儿53例的临床特征及预后状况分析

Clinical Characteristics and Prognosis of 53 Children with MPP Complicated with Pleural Effusion

目的研究儿童肺炎支原体肺炎(MPP)合并胸腔积液患儿53例的临床特征及预后状况。方法选择2020年8月至2022年7月的53例MPP合并胸腔积液患儿进行本次研究,选取53例MPP患儿作为MPP组,收集两组临床资料、分析临床特征及预后状况。结果MPP合并PE组学龄期儿童占比、肺实变、使用激素、发热时间、住院时间为[28.30%(15/53)、86.79%(46/53)、90.56%(48/53)、(7.29±1.01)d、(12.03±1.52)d]均显著高于MPP组[11.32%(6/53)、22.64%(12/53)、18.86%(10/53)、(3.36±0.38)d、(6.02±0.96)d](P<0.05);MPP合并PE组C-反应蛋白(CRP)、血清乳酸脱氢酶(LDH)、血清免疫球蛋白A(IgA)水平为[(42.52±10.31)mg/L、(560.61±132.67)U/L、(1.39±0.30)g/L]显著高于MPP组[(14.05±6.38)mg/L、(470.98±102.50)U/L、(0.90±0.26)g/L](P<0.05);MPP合并PE组使用全身糖皮质激素、单纯阿奇霉素药物起效时间、并发症发生率、出院后胸部影像学吸收时间为[22.64%(12/53)、(5.76±0.91)、30.18%(16/53)、(2.51±0.82)月]均显著高于MPP组[1.88%(1/53)、(3.82±0.52)、15.09%(8/53)、(1.32±0.20)月](P<0.05)。结论MPP合并PE患儿以肺实变为主要类型,可使CRP、LDH水平明显升高,可增强体液免疫反应,表明MPP合并PE可造成更为严重的免疫损伤,在治疗时需要给予免疫调节。

Objective To study the clinical characteristics and prognosis of 53 children with MPP complicated with pleural effusion.Methods 53 children with MPP and pleural effusion who received treatment in our hospital from August 2020 to July 2022 were selected for this study,53 children with simple MPP were selected as the simple MPP group,the clinical data of the two groups were collected and the clinical characteristics and prognosis were analyzed.Results The proportion of school-age children,lung consolidation,use hormone,fever time and hospitalization time in MPP combined with PE group were[28.30%(15/53),86.79%(46/53),90.56%(48/53),(7.29±1.01)d,(12.03±1.52)d]significantly higher than those in MPP group[11.32%(6/53),22.64%(12/53),18.86%(10/53),(3.36±0.38)d,(6.02±0.96)d]the difference was statistically significant(P<0.05).The levels of CRP,LDH and IgA in MPP combined with PE group were[(42.52±10.31)mg/L,(560.61±132.67)U/L,(1.39±0.30)g/L]significantly higher than those in the MPP group[(14.05±6.38)mg/L,(470.98±102.50)U/L,(0.90±0.26)g/L](P<0.05).The onset time of systemic glucocorticoids,azithromycin alone,the incidence of complications,and the time of chest imaging absorption after discharge in the MPP plus PE group were[22.64%(12/53),(5.76±0.91),30.18%(16/53),(2.51±0.82)mouth]significantly higher than those in the MPP group[1.88%(1/53),(3.82±0.52),15.09%(8/53),(1.32±0.20)mouth](P<0.05).Conclusion Pulmonary consolidation is the main type of MPP combined with PE,which can significantly increase the levels of CRP and LDH,and enhance the humoral immune response,indicating that MPP combined with PE can cause more serious immune damage,and immune regulation is required during treatment.