肺炎支原体肺炎所致难治性哮喘临床特点及危险因素分析  

Clinical characteristics and risk factors of mycoplasma pneumoniae pneumonia-induced refractory asthma

作　　者：李娜[1] 徐香琴 丘国清 申严[1] LI Na;XU Xiang-qin;QIU Guo-qing(Department of Respiratory and Critical Care Medicine,Longgang Central Hospital,Shenzhen 518116,China)

机构地区：[1]深圳市龙岗中心医院呼吸与危重症医学科,518116

出　　处：《中国实用医药》2022年第26期32-35,共4页China Practical Medicine

摘　　要：目的分析肺炎支原体肺炎(MPP)所致难治性哮喘的临床特点及相关危险因素。方法回顾性分析126例MPP患者的临床资料,依据有无发生难治性哮喘将患者分为哮喘组(20例)与正常组(106例)。正常组采用阿奇霉素治疗,哮喘组在正常组基础上采用沙丁胺醇雾化吸入治疗。对比两组患者临床特点;统计两组患者的性别、年龄、个人过敏史、家族哮喘史、免疫球蛋白(IgE)水平、用力呼出量为25%~75%肺活量间的平均呼气流量(FEF25%~75%)占预计值的百分比、特异性皮炎史、化工材料或者粉尘接触史等,并采用Logistic多因素分析MPP所致难治性哮喘的危险因素。结果哮喘组的发热持续时间(5.48±0.95)d及住院时间(12.14±1.86)d均长于正常组的(3.62±0.62)、(7.25±1.94)d,差异有统计学意义(P<0.05)。哮喘组支原体IgM及IgG阳性率分别为90.00%、85.00%,均高于正常组的23.58%、26.42%,差异有统计学意义(P<0.05)。哮喘组支气管镜下显示黏膜充血水肿、炎性狭窄或者坏死及痰栓阻塞发生率分别为80.00%、70.00%、60.00%,均高于正常组的9.43%、7.55%、5.66%,差异有统计学意义(P<0.05)。两组个人过敏史、家族哮喘史、IgE水平、FEF25%~75%占预计值的百分比和特异性皮炎史对比,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,个人过敏史、家族哮喘史、IgE水平高、FEF25%~75%占预计值的百分比及特异性皮炎史均为MPP所致难治性哮喘的危险因素(P<0.05)。结论MPP所致难治性哮喘患者的发热持续时间及住院时间较长,支原体IgM、IgG阳性率较高,且支气管镜下的异常表现更明显,个人过敏史、家族哮喘史、IgE水平高、FEF25%~75%占预计值的百分比低及特异性皮炎史均是MPP所致难治性哮喘的危险因素,需要结合这些因素采用针对性治疗方式控制患者病情。Objective To analyze the clinical characteristics and risk factors of mycoplasma pneumoniae pneumonia(MPP)-induced refractory asthma.Methods The clinical data of 126 patients with MPP were retrospectively analyzed,and the patients were divided into an asthma group(20 cases)and a normal group(106 cases)based on the presence or absence of refractory asthma.The normal group was treated with azithromycin and the asthma group was treated with salbutamol nebulized inhalation on the basis of the normal group.The clinical characteristics of the two groups were compared,and the gender,age,personal history of allergy,family history of asthma,immunoglobulin(IgE)level,25%-75%forced expiratory flow(FEF25%-75%)as a percentage of the predicted value,the history of atopic dermatitis,and the history of chemical material or dust exposure in the two groups were counted.Logistic multifactor analysis was also used to analyze the risk factors for refractory asthma due to MPP.Results The duration of fever(5.48±0.95)d and hospital stay(12.14±1.86)d in the asthma group were longer than(3.62±0.62)and(7.25±1.94)d in the normal group,and the differences were all statistically significant(P<0.05).The positive rates of mycoplasma IgM and IgG in the asthma group were 90.00% and 85.00%,which were higher than 23.58% and 26.42% in the normal group,and the differences were statistically significant(P<0.05).The incidence of mucosal congestion and edema,inflammatory stenosis or necrosis,and sputum embolism and obstruction in the asthma group were 80.00%,70.00%and 60.00%,which were higher than 9.43%,7.55% and 5.66% in the normal group,and the difference were all statistically significant(P<0.05).The personal history of allergy,family history of asthma,IgE level,FEF25%-75% as a percentage of the predicted value and history of atopic dermatitis between the two groups were compared,and the difference was statistically significant(P<0.05).Multifactorial Logistic regression analysis showed that personal history of allergy,family history of asthma,high

关 键 词：肺炎支原体肺炎 难治性哮喘 临床特点 危险因素 

分 类 号：R562.25[医药卫生—呼吸系统]