住院儿童难治性肺炎支原体肺炎相关因素分析  

Analysis on related factors of refractory Mycoplasma pneumoniae pneumonia in hospitalized children

作　　者：吴佩琼 余嘉璐 谢志伟 陈晨 李金凤 

机构地区：[1]广州市妇女儿童医疗中心呼吸科,广东广州510000

出　　处：《中国妇幼保健》2016年第5期974-976,共3页Maternal and Child Health Care of China

基　　金：广东省科技计划项目(20120314);国家卫计委临床重点专科小儿呼吸项目资助

摘　　要：目的 进一步了解难治性肺炎（MMP）支原体肺炎的临床特点,早期识别难治性肺炎支原体肺炎。方法 用病例对照的研究方法,回顾性分析住院儿童难治性肺炎支原体肺炎相关因素经卡方,两独立样本t检验和条件Logistic回归分析。结果共收集了128例MPP患儿进入分析。难治性MPP组38例,男18例;普通MPP组90例,男56例。①单因素分析显示,难治性MPP组住院天数显著高于普通MPP组（P均〈0.05）;发热超过10d（χ~2=27.746）和胸腔积液（χ~2=43.308）与难治性MPP相关（P均〈0.05）LDH、ALT、AST和CRP水平难治性MPP组均显著高于普通MPP组（P〈0.05）。②选择单因素分析后有统计学意义的临床、实验室指标行逐步Logistic回归分析,发热天数（OR=1.422,95%CI：1.040~1.944）、血清ALT水平（OR=1.141,95%CI：1.024~1.271）和CRP值（OR=1.041,95%CI：1.017~1.065）是难治性MPP的独立相关因素。结论 疾病早期存在持续高热、CRP增高、肺外损伤,胸腔积液是进展为难治性MPP的独立相关因素,应早期积极干预,预防并发症的发生。Objective To further understand the clinical characteristics of refractory Mycoplasma pneumoniae pneumonia （ MMP）, ear- ly discriminate refractory MMP. Methods A case-control study was preformed to retrospectively analyze the related factors of refractory MMP in hospitalized children, then the data was analyzed by chi-square test, two independent sample t test, and conditional logistic regres- sion analysis. Results A total of 128 MPP children were collected, then they were divided into refractory MPP group （38 children, 18 chil- dren were boys） and general MPP group （90 children, 56 children were boys） . Univariate analysis showed that the hospitalization time of refractory MPP group was statistically significantly longer than that of general MPP group （P〈0.05） ; fever over 10 days （X2= 27. 746） and pleural effusion （X2 = 43. 308 ） were correlated with refractory MPP （ P〈0.05 ） ; the levels of lactate dehydrogenase （ LDH）, alanine amin- otransferase （ALT）, aspartate transaminase （AST）, and C-reactive protein （CRP） in refractory MPP group were statistically significantly higher than those in general MPP group （P〈0. 05 ） . The clinical and laboratory indexes with statistically significant differences after univari- ate analysis were enrolled into stepwise logistic regression analysis, the duration time of fever （OR= 1. 422, 95% CI： 1. 040-1. 944） , ser- um ALT level （ OR= 1. 141, 95% CI： 1. 024-1. 271 ） , and CRP level （ OR= 1. 041,95% CI： 1. 017- 1. 065） were independent risk fac- tors of refractory MPP. Conclusion Persistent fever, high level of serum ALT, extrapulmonary injury, and pleural effusion are independent risk factors of refractory MPP, early and active intervention can prevent the occurrence of complications.

关 键 词：肺炎支原体 难治性肺炎支原体肺炎 相关因素 儿童 

分 类 号：R563.1[医药卫生—呼吸系统]