成人社区获得性肺炎支原体肺炎的危险因素  

Risk factor for community-acquired Mycoplasma pneumoniae pneumonia in adults

作　　者：任圆 王艳[2] 梁瑞峰[1] 郝斌威 王宏霞[2] REN Yuan;WANG Yan;LIANG Rui-feng;HAO Bin-wei;WANG Hong-xia(School of Public Health,Shanri Medical University,Taiyuan,Shanxi 03000l,China;不详)

机构地区：[1]山西医科大学公共卫生学院,山西太原030001 [2]山西医科大学第三医院(山西白求恩医院、山西医学科学院同济山西医院)感染病科,山西太原030032 [3]山西医科大学第三医院(山西白求恩医院、山西医学科学院同济山西医院)呼吸与危重症医学科,山西太原030032

出　　处：《中华医院感染学杂志》2023年第16期2437-2441,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(82100053)。

摘　　要：目的 分析成人肺炎支原体肺炎(MPP)的危险因素。方法 分析2021年1月1日-2021年12月31日山西白求恩医院住院部确诊为社区获得性肺炎(CAP)的所有成人患者的临床资料,根据纳入和排除标准,最终348例患者作为研究对象,根据是否感染肺炎支原体将其分为MPP组和非MPP组。比较两组患者一般资料、临床表现、实验室检查及影像学检查结果。采用单因素分析和多因素Logistic回归分析方法分析成人MPP的危险因素。结果 MPP的发生率约为36.1%;单因素分析:性别、年龄、发病季节、基础疾病、体温、干咳、咽部不适、胸闷气短、畏寒、寒战、乏力、头晕、降钙素原、树芽征和胸腔积液与MPP的发生相关(P<0.05);多因素Logistic回归分析:年龄[18~44岁(OR=5.674,95%CI:2.551~12.623)]、体温[38.1~39.0℃(OR=3.031,95%CI:1.239~7.415)、39.1~41.0℃(OR=7.418,95%CI:2.803~19.634)]、干咳[OR=2.694,95%CI:1.225~5.920]及树芽征[OR=2.464, 95%CI:1.123~5.409]是成人MPP的独立危险因素。结论 18~44岁,中高程度发热,出现干咳症状及树芽征的CAP患者是MPP的高危人群。临床医生应尽早进行MPP的危险因素筛查,识别高危患者并制定有效的诊疗方案。OBJECTIVE To analysis the risk factors for Mycoplasma pneumoniae pneumonia(MPP)in adults.METHODS The clinical data of all adult patients diagnosed with community-acquired pneumonia(CAP)in the inpatient department of Shanxi Bethune Hospital from Jan 1,2021 to Dec 31,2021 were analyzed.According to the inclusion and exclusion criteria,348 patients were eventually included in the study,and they were divided into the MPP group and non-MPP group according to whether they were infected with MP.The general information,clinical manifestations,laboratory examination and imaging examination between the two groups were compared.The risk factors for adult MPP were analyzed by univariate analysis and multivariate logistic regression analysis.RESULTS The incidence of MPP was about 36.1%.Univariate analysis indicated that gender,age,season of onset,underlying disease,body temperature,dry cough,pharyngeal discomfort,chest tightness and shortness of breath,aversion to cold,chills,fatigue,dizziness,procalcitonin,tree-in-bud sign and pleural effusion were associated with the occurrence of MPP(P<0.05).Multivariate logistic regression analysis showed that 18-44 years(OR=5.674,95%CI:2.551-12.623),body temperature of 38.1-39.0℃(OR=3.031,95%CI:1.239-7.415)and 39.1-41.0℃(OR=7.418,95%CI:2.803-19.634),dry cough(OR=2.694,95%CI:1.225-5.920)and tree-in-bud sign(OR=2.464,95%CI:1.123-5.409)were independent risk factors for MPP in adults.CONCLUSION Patients with CAP aged from18 to 44 years with moderate to high fever,dry cough symptoms and tree-in-bud sign have high risk for MPP.Clinicians should screen for risk factors for MPP as early as possible to identify high-risk patients and make effective treatment decisions.

关 键 词：成人肺炎支原体肺炎 社区获得性肺炎 临床特征 危险因素 

分 类 号：R563.1[医药卫生—呼吸系统]