重症肺炎支原体性肺炎临床特点及危险因素分析

Clinical characteristics and risk factors of severe Mycoplasma pneumoniae pneumonia

目的分析重症支肺炎原体性肺炎临床特点及危险因素,为早期诊断提供依据。方法选取安徽省儿童医院呼吸科2022年1月—2023年9月收治的98例支原体肺炎患儿,给予对症治疗,根据肺炎诊断标准分组,A组为重症患儿,B组为轻中度患儿,比较入院时一般资料及临床特点,分析影响重症的危险因素。结果A组患儿体温>39℃(64.00%)、C反应蛋白(CRP)水平[(35.26±2.74)mg/L]、大片状阴影范围(76.00%)、黏液栓堵塞比例(28.00%)、大环内酯类药物使用时间[(5.71±1.06)d]均高于B组,差异有统计学意义(χ2=4.042,P<0.001;t=36.886,P<0.001;χ2=10.573,P=0.001;χ2=4.731,P=0.030;t=11.112,P<0.001)。经二元Logistic回归分析,发热程度、CRP水平、大片状阴影范围、黏液栓堵塞、大环内酯类药物使用时间是重症患儿的危险因素(P<0.05)。经ROC曲线分析,发热、CRP水平、大片状阴影、大环内酯类药物使用时间、黏液栓堵塞的灵敏度分别为72.00%、72.00%、76.00%、76.00%、92.00%;特异度分别为75.34%、78.08%、76.71%、82.19%、79.45%、90.41%。结论发热、CRP水平、肺病变范围、黏液栓堵塞、大环内酯类药物使用时间是重症支原体肺炎的危险因素。

Objective To analyze the clinical characteristics and risk factors of severe Mycoplasma pneumoniae pneumonia(SMPP)in children,and to provide a basis for early diagnosis.Methods Ninety-eight children with Mycoplasma pneumonia(MPP)admitted to the Department of Respiratory Medicine,Anhui Children’s Hospital from January 2022 to September 2023 were selected and given symptomatic treatment.The children were divided according to the diagnostic criteria for pneumonia.Group A included the children with severe disease,group B included mild to moderate children.The general data and clinical characteristics at admission were compared,and the risk factors affecting SMPP were analyzed.Results In group A,the body temperature above 39℃(64.00%),C-reactive protein(CRP)level[(35.26±2.74)mg/L],large shadow lesion range(76.00%),mucus plug blockage ratio(28.00%),and macrolide drug use time[(5.71±1.06)days]were all higher than those of group B,the differences were statistically significant(χ2=4.042,P<0.001.t=36.886,P<0.001.χ2=10.573,P=0.001.χ2=4.731,P=0.030.t=11.112,P<0.001).According to binary logistic regression analysis,fever level,CRP level,large shadow lesion range,mucus plug blockage and duration of macrolide drug use were the risk factors for SMPP in children(P<0.05).ROC curve analysis showed that the sensitivity of body temperature>39℃,CRP level,large shadows,macrolide drug use time,and mucus plug blockage was 72.00%,72.00%,76.00%,76.00%,92.00%,respectively.The specificity was 75.34%,78.08%,76.71%,82.19%,79.45%and 90.41%,respectively.Conclusion Body temperature>39℃,CRP level,lesion range,mucous plug blockage and duration of macrolides use were all the risk factors for children with SMPP.