儿童肺炎支原体肺炎并发黏液栓的高危因素  

High-risk factors of Mycoplasma pneumoniae pneumonia complicated with mucus plugsin children

作　　者：李桂涛 毛国顺[1] 赵永[1] 朱影[1] 戴红臣[1] 孙良[2] LI Gui-tao;MAO Guo-shun;ZHAO Yong;ZHU Ying;DAI Hong-chen;SUN Liang(Department of Pediatrics,Fuyang People′s Hospital Affiliated to Anhui Medical University;Department of infectious diseases,Fuyang Centers for Disease Control and Prevention,Fuyang,Anhui 236000,China)

机构地区：[1]阜阳市人民医院儿科,安徽阜阳236000 [2]阜阳市疾病预防控制中心传染病科,安徽阜阳236000

出　　处：《临床肺科杂志》2022年第5期696-700,共5页Journal of Clinical Pulmonary Medicine

基　　金：阜阳市卫科教(No.2018-248)。

摘　　要：目的探讨儿童肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)并发黏液栓形成的高危因素。方法回顾性分析2019年9月至2021年6月入住阜阳市人民医院儿科行电子支气管镜灌洗的MPP患儿临床资料,根据电子支气管镜下有无黏液栓,分成观察组(黏液栓组)和对照组,对比两组患儿的临床特征,对MPP患儿并发黏液栓的危险因素进行单因素分析,结果中有统计学意义的变量再进行多因素Logistic回归分析,采用受试者工作特征(ROC)曲线分析相关因素评估MPP并发黏液栓的预测价值。结果共纳103例MPP患儿,观察组54例,对照组49例。单因素分析显示观察组肺部病变累及肺叶≥2个、热程、热峰、WBC、CRP、LDH、D二聚体、住院时间、住院费用均高于对照组,对比均有统计学意义。多因素Logistic回归分析显示CRP、LDH、热程天数是儿童MPP并发黏液栓的高危因素。其ROC曲线临界值分别为CRP≥29.34mg/L、LDH≥353.95U/L、热程天数≥8.5d。结论MPP患儿出现CRP≥29.34mg/L、LDH≥353.95U/L、热程天数≥8.5d,极有可能并发黏液栓,需积极行电子支气管镜检查及治疗。Objective To explore the high-risk factors of Mycoplasma pneumoniae pneumonia(MPP)complicated with mucus plugs formation in children.Methods The clinical data of MPP children who were admitted to the Department of Pediatrics of Fuyang People′s Hospital and underwent electronic bronchoscopy lavage from September 2019 to June 2021 were retrospectively analyzed.According to whether there were mucus plugs under the electronic bronchoscope,they were divided into an observation group(mucus plug group)and a control group.The clinical characteristics of the two groups of children were compared,and the risk factors of MPP children with mucus in the airway were analyzed by univariate analysis.The variables with statistical significance in the results were further analyzed by multivariate logistic regression analysis.The receiver operating characteristic(ROC)curve was used to analyze the predicted value of relevant factors in MPP complicated with mucous plugs.Results A total of 103 children with MPP were enrolled,54 cases in the observation group and 49 cases in the control group.Univariate analysis showed that pulmonary lesions involving≥2 lobes,heat duration,heat peak,WBC,CRP,LDH,D-dimer,hospitalization time,and hospitalization cost in the observation group were all higher than those in the control group,and the comparisons were statistically significant.Multivariate Logistic regression analysis showed that CRP,LDH,and heat duration days were high-risk factors for MPP complicated with mucus plugs in children.The critical values of the ROC curve were CRP≥29.34mg/L,LDH≥353.95U/L,and heat duration≥8.5d.Conclusion MPP children with CRP≥29.34mg/L,LDH≥353.95U/L,and heat duration≥8.5d are very likely to be complicated with mucus plugs.Electronic bronchoscopy and treatment should be actively performed.

关 键 词：肺炎支原体肺炎 电子支气管镜 黏液栓 高危因素 

分 类 号：R725.6[医药卫生—儿科]