肺炎支原体肺炎发生肺外并发症的危险因素  

Risk factors of extrapulmonary complications after Mycoplasma pneumoniae pneumonia

作　　者：王全[1] 蒋健飞[2] 赵德育[1] 

机构地区：[1]南京医科大学附属南京儿童医院呼吸科,210008 [2]铜陵市人民医院儿科

出　　处：《中华实用儿科临床杂志》2013年第10期749-751,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的探讨肺炎支原体肺炎（MPP）发生肺外并发症的危险因素，为指导临床正确诊断、有效治疗及协助病情判断、减少肺外并发症的发生提供依据。方法回顾性分析2008年1月至2010年1月收住院确诊为MPP的234例患儿的临床资料，根据其有无合并肺外并发症分为肺外并发症组（107例）和无肺外并发症组（127例），比较2组患儿的年龄、性别、体温、热程、胸腔积液、肺部CT（或胸片）病变部位、WBC总数、ESR、CRP及发病后开始应用大环内酯类抗生素的时间等。结果肺外并发症全身各系统均有发生，其中以循环系统、消化系统最为多见，分别为占11．11％、10．68％。其他系统损害分别为血液系统（8．12％）、皮肤（5．56％）、泌尿系统（1．71％）、神经系统（2．14％）等。2个或2个以上的脏器同时受累者11例（4．70％）。对可能影响肺外并发症发生的10种危险因素进行单因素分析，结果显示2组的CRP（P〈0．05）、ESR（P〈0．05）、肺部实变影（P〈0．叭）和发病超过7d使用大环内酯类抗生素（P〈0．01）相比差异均有统计学意义。而2组患儿的年龄、性别、体温、热程、胸腔积液、WBC总数相比，差异均无统计学意义（P均〉0．05）。结论MPP肺外并发症各系统脏器都可发生，严重者甚至造成多系统脏器损害。CRP、ESR、肺部实变影和发病7d后使用大环内酯类抗生素为发生肺外并发症的危险因素。Objective To identify the risk factors of extrapulmonary complications in children with Mycoplas- ma pneumoniae pneumonia （MPP） , in order to provide evidence for the correct clinical diagnosis and effective treat- ment to reduce the incidence of extrapulmonary complications. Methods The clinical data of 234 hospitalized children with MPP from Jan. 2008 to Jan. 2010 were retrospectively reviewed. Based on the findings of extrapulmonary complica- tions, the subjects were divided into 2 groups：the extrapulmonary complications group （107 cases） and non-extrapulmo- nary complications group （127 cases）. The comparison was made between the 2 groups in age,gender,fever,the mani- festation of pneumonia on X-ray or CT scan, white blood cell count, erythrocyte sedimentation rate （ESR） , C reaction protein （CRP） and application of macrolide medicine etc. Results All the systems were involved in extrapulmonary complications ,the most 2 involved systems were circulatory system and digestive system, ranking 11.11% and 10.68% respectively. The other involved systems were the blood system （8.12% ）, skin （5.56%）, urinary （1.71% ）, and nerv- ous system（2.14% ）, 11 cases（4.70% ）had two or more organ damages. The results of analysis indicated that the re- lated risk factors included CRP（ P 〈 0.05 ）, ESR（ P 〈 0.05 ）, lung patchy shadow （ P 〈 0.01 ） and application of macro- lide medicine more than 7 days of sickness （P 〈 0.01 ）. But there was no significant difference between the 2 groups in age, gender, fever,pleural effusion, white blood cell count （ all P 〉 0.05）. Conclusions Extrapulmonary complications with MPP can be involved in every system. In severe cases, multi-system organ can be suffered. CRP, ESR,lung patchy shadow and application of Macrolide medicine within 7 days of sickness are factors associated with extrapulmonary complications.

关 键 词：肺炎支原体肺炎 肺外并发症 危险因素 儿童 

分 类 号：R725.6[医药卫生—儿科]