儿童肺炎支原体坏死性肺炎预测指标研究  

Study on predictive indicators of Mycoplasma pneumoniae necrotizing pneumonia in children

作　　者：王秀芳[1] 李伟霞 张艳丽[1] 宋哲[1] WANG Xiufang;LI Weixia;ZHANG Yanli;SONG Zhe(Department of Pediatric Respiration, Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052, Henan, China)

机构地区：[1]郑州大学第三附属医院小儿呼吸科

出　　处：《临床儿科杂志》2019年第6期409-412,共4页Journal of Clinical Pediatrics

摘　　要：目的分析儿童肺炎支原体坏死性肺炎(MPNP)临床特征及实验室结果,寻找MPNP早期诊断指标。方法回顾分析40例MPNP及60例难治性肺炎支原体肺炎(RMPP)的临床资料,比较两组患儿的差异,并绘制ROC曲线,寻找预测MPNP发生的指标。结果MPNP组患儿的住院时间,发热时间,合并肝损伤、胸腔积液的比例,外周血白细胞(WBC)计数,中性粒细胞比例,C反应蛋白,D-二聚体,乳酸脱氢酶均明显高于RMPP组,差异有统计学意义(P<0.05)。进一步行多因素logistic回归分析显示,WBC(OR=1.35,95%CI:1.09~1.68)、发热时间(OR=1.22,95%CI:1.03~1.44)是MPNP发生的危险因素(P均<0.05)。绘制WBC、发热时间预测MPNP的ROC曲线,发现WBC>12.6×10^9/L、发热时间>13.5天对于预测MPNP发生有较高价值(AUC=0.80、0.83,P均<0.001)。结论当肺炎支原体大叶性肺炎患儿出现发热时间>13.5天,WBC>12.6×10^9/L时,需警惕MPNP的发生。Objective To analyze the clinical features and laboratory results of Mycoplasma pneumoniae necrotizing pneumonia(MPNP)in children,and to search for early diagnostic indicators of MPNP.Method The clinical data of MPNP in 40 children and refractory Mycoplasma pneumoniae pneumonia(RMPP)in 60 children were retrospectively analyzed.The differences between the two groups were compared,and ROC curves were drawn to find the indicators to predict the occurrence of MPNP.Results The hospitalization time,fever duration,the proportion of liver injury and pleural effusion,peripheral white blood cell(WBC)count,neutrophil ratio,C-reactive protein,D-dimer and lactate dehydrogenase in MPNP group were signi ficantly higher than those in RMPP group,and there were signi ficant differences(all P<0.05).Multivariate logistic regression analysis showed that WBC(OR=1.35,95%CI:1.09~1.68)and fever time(OR=1.22,95%CI:1.03~1.44)were risk factors for MPNP(all P<0.05).The ROC curves of WBC and fever duration for predicting MPNP were drawn.It was found that WBC>12.6×10^9/L and fever duration>13.5 days were of high value in predicting MPNP(AUC=0.80,0.83,all P<0.001).Conclusion When fever duration was>13.5 days and WBC was>12.6×10^9/L in children with lobar pneumonia induced by Mycoplasma pneumoniae,the clinician should be alerted to occurrence of MPNP.

关 键 词：肺炎支原体 坏死性肺炎 预测指标 儿童 

分 类 号：R725.6[医药卫生—儿科]