儿童肺炎支原体肺炎混合感染特征及危险因素分析  

Characteristics and risk factors of Mycoplasma Pneumoniae Pneumonia mixed infection in children

作　　者：孙慧[1] 郭艳梅[1] 李君娥[1] 霍习敏[1] 徐梅先[1] SUN Hui;GUO Yanmei;LI Jun’e;HUO Ximin;XU Meixian(Intensive Care Unit,Hebei Children’s Hospital,Hebei Province,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院重症监护科,河北石家庄050031

出　　处：《中国医药导报》2020年第32期83-86,共4页China Medical Herald

基　　金：河北省医学科学研究重点课题项目(20170386)。

摘　　要：目的探讨儿童肺炎支原体肺炎(MPP)混合感染特征及危险因素。方法选择2016年6月—2018年6月于河北省儿童医院住院的615例MPP患儿,所有患儿进行血常规、C反应蛋白(CRP)、衣原体/支原体IgM检测及痰细菌培养。结果615例确诊MPP患儿中,单一感染组489例,混合感染组126例。混合感染组中,混合病毒组72例、混合细菌组33例、混合衣原体组21例。单一感染组和混合感染各组的年龄、发热>10 d及肺外并发症比较,差异有统计学意义(P<0.05)。单一感染组和混合感染各组的性别、喘息比较,差异无统计学意义(P>0.05)。四组白细胞计数(WBC)、中性粒细胞(NEU)、CRP水平比较,差异均有高度统计学意义(P<0.01)。混合细菌组WBC和CRP水平高于单一感染组(P<0.05),混合病毒组NEU水平低于单一感染组(P<0.05)。多因素logistic分析显示,年龄(OR=0.732,P<0.01)是混合病毒感染的保护因素,肺外并发症(OR=1.429,P<0.05)是混合病毒感染的独立危险因素;年龄(OR=0.548,P<0.01)是混合细菌感染的保护因素,发热>10 d(OR=3.593,P<0.05)、WBC(OR=2.593,P<0.05)是混合细菌感染的独立危险因素;年龄(OR=3.392,P<0.01)是混合衣原体感染的独立危险因素。结论本地区MPP混合感染检出率较低,年龄越小混合感染检出率越高,混合感染病原体以病毒为主,其次为细菌感染,年幼儿以混合病毒和细菌感染为主,年长儿应警惕混合衣原体感染,发热时间长、WBC升高须注意细菌感染。Objective To investigate the characteristics and risk factors of mixed infection of Mycoplasma Pneumoniae Pneumonia(MPP)in children.Methods Six hundred and fifteen MPP children hospitalized in Hebei Children’s Hospital from June 2016 to June 2018 were selected.Blood routine,C-reactive protein(CRP),Chlamydia/Mycoplasma IgM and sputum bacterial culture were performed in all patients.Results Among 615 children with MPP,489 cases were in single infection group and 126 cases in mixed infection group.In mixed infection group,72 cases in mixed virus group,33 cases in mixed bacteria group,21 cases in mixed Chlamydia group.There were significant differences in age,fever>10 days and extrapulmonary complications among four groups(P<0.05).There was no significant difference in gender and wheezing between single infection group and mixed infection groups(P>0.05).There were significant differences in WBC,NEU and CRP among single infection group and mixed virus group,mixed bacteria group,mixed Chlamydia group(P<0.01).The levels of WBC and CRP in mixed bacteria group were higher than those in single infection group(P<0.05),and NEU level in mixed virus group was lower than that in single infection group(P<0.05).Multivariate logistic analysis showed that age(OR=0.732,P<0.01)was a protective factor for mixed virus infection,and extrapulmonary complication(OR=1.429,P<0.05)was independent risk factor for mixed virus infection.Age(OR=0.548,P<0.01)was a protective factor for mixed bacterial infection.Fever>10 days(OR=3.593,P<0.05)and WBC(OR=2.593,P<0.05)were independent risk factors for mixed bacterial infection.Age(OR=3.392,P<0.01)was an independent risk factor for mixed Chlamydia infection.Conclusion The detection rate of MPP mixed infection is lower in this area.The younger the age is,the higher the detection rate of MPP mixed infection is.The main pathogen of mixed infection is virus,followed by bacterial infection.The children are mainly mixed virus and bacterial infection.The older children should be alert to the mixed Chlamydi

关 键 词：肺炎支原体 混合感染 肺炎 儿童 

分 类 号：R563.1[医药卫生—呼吸系统]