儿童肺炎支原体肺炎并发大叶性肺炎的危险因素  

Risk factors for lobar pneumonia in children with Mycoplasma pneumoniae pneumonia

作　　者：王雪[1] 高密密 尹力 刘安娜 李芳[1] WANG Xue;GAO Mi-mi;YIN Li;LIU An-na;LI Fang(The Second Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China)

机构地区：[1]河北医科大学第二医院儿科,河北石家庄050000

出　　处：《中华医院感染学杂志》2021年第2期277-280,共4页Chinese Journal of Nosocomiology

基　　金：河北省医学科学研究重点基金资助项目(20180285)。

摘　　要：目的分析肺炎支原体(MP)感染大叶性肺炎的危险因素,为肺炎支原体肺炎(MPP)的诊断和治疗工作提供研究依据。方法选取2019年6月-2020年6月河北医科大学第二医院收治的150例MPP患儿作为研究对象,根据是否发生大叶性肺炎将其分为研究组95例(大叶性肺炎)和对照组55例(非大叶性肺炎),对两组患儿的临床特征、入院常规实验室指标进行回顾性调查,分析大叶性肺炎发生的危险因素。结果研究组患儿的年龄、发热时间、发病至应用大环内酯类药物时间及心动过速、胸腔积液、肺外并发症的发生比例均高于对照组(P<0.05);研究组患儿的外周血中性粒细胞百分比、血清C-反应蛋白(CRP)、乳酸脱氢酶(LDH)及红细胞沉降率(ESR)分别为(64.08±12.06)%、(36.62±25.08)mg/L、(364.43±152.23)U/L及(39.91±16.65)mm/h均高于对照组(P<0.05);Logistic多元回归分析结果显示,MP感染患儿发生大叶性肺炎与发热时间、发病至应用大环内酯类药物时间及入院时血清CRP水平具有相关性(P<0.05)。结论 MP感染患儿发生大叶性肺炎与发热、应用大环内酯类药物及CRP水平等有关,临床医生应对其风险给予全面的评估并采取有效的干预治疗措施,及时逆转疾病的重症化趋势,达到改善患儿预后的目的。OBJECTIVE To investigate the risk factors for lobar pneumonia caused by Mycoplasma pneumoniae(MP) infection so as to provide guidance for diagnosis and treatment of M. pneumoniae pneumonia(MPP). METHODS A total of 150 children with MPP who were treated in The Second Hospital of Hebei Medical University from Jun 2019 to Jun 2020 were recruited as the study subjects and divided into the study group with 95 cases(lobar pneumonia) and the control group with 55 cases(non-lobar pneumonia) according to the status of lobar pneumonia.The clinical characteristics and routine laboratory test indexes at admission were retrospectively investigated, and the risk factors for the lobar pneumonia were observed. RESULTS The age, time of fever, time interval between onset and use of macrolides, proportions of the children with tachycardia, pleural effusion and extrapulmonary complications were significantly higher in the study group than in the control group(P<0.05).The peripheral blood neutrophils percentage, serum C-reactive protein(CRP), lactate dehydrogenase(LDH) and erythrocyte sedimentation rate(ESR) of the study group were respectively(64.08±12.06)%,(36.62±25.08)mg/L,(364.43±152.23)U/L and(39.91±16.65)mm/h, significantly higher than those of the control group(P<0.05).Multivariate logistic regression analysis showed that the incidence of lobar pneumonia in the children with MP infection was associated with the time of fever, time interval between onset and use of macrolides and serum CRP level at admission(P<0.05). CONCLUSION The incidence of lobar pneumonia in the children with MP infection is associated with fever, use of macrolides and CRP level.It is necessary for clinicians to comprehensively evaluate the risk and take effective intervention measures so as to reverse the trend of severe disease in time and improve the prognosis of the children.

关 键 词：患儿 肺炎支原体 大叶性肺炎 危险因素 

分 类 号：R375.2[医药卫生—病原生物学]