儿童难治性肺炎支原体肺炎早期临床预测因素  

Early clinical predictors of refractory Mycoplasma pneumoniae pneumonia in children

作　　者：马瑞[1] 裴亮[1] MA Rui;PEI Liang(Pediatric Intensive Care Unit,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院儿童重症监护病房,沈阳110004

出　　处：《中国医科大学学报》2023年第11期1015-1017,1024,共4页Journal of China Medical University

基　　金：辽宁省科技重大专项计划(2020JH1/10300001)。

摘　　要：目的通过比较难治性肺炎支原体肺炎(RMPP)和普通肺炎支原体肺炎(MPP)的临床资料,探讨RMPP早期临床预测因素。方法回顾性分析2018年1月至2020年12月中国医科大学附属盛京医院儿童重症监护病房救治的MPP病例93例,其中24例为RMPP,分析其病程第1周内的临床数据,应用t检验、χ^(2)检验和(或)Mann-Whitney U检验对14个RMPP可能的临床因素进行分析,并采用logistic回归分析筛选预测RMPP的潜在临床因素。结果93例MPP患儿中,RMPP 24例,发病率25.8%。单因素分析显示,RMPP组和普通MPP组患儿年龄、乳酸脱氢酶水平和D-二聚体均存在统计学差异(P<0.05)。多因素logistic回归分析显示,年龄(OR=1.277,P=0.027)、乳酸脱氢酶水平(OR=1.047,P=0.001)和D-二聚体(OR=1.243,P=0.004)与RMPP发病有关。结论患儿年龄及病程第1周内乳酸脱氢酶和D-二聚体水平可能是早期预测RMPP的临床相关因素。Objective To investigate the early clinical predictors of refractory Mycoplasma pneumoniae pneumonia(RMPP)in children by comparing the clinical data of RMPP and general M.pneumoniae pneumonia(MPP).Methods In this retrospective analysis,of the 93 children with MPP treated at Shengjing Hospital of China Medical University between January 2018 and December 2020,24 were diagnosed with RMPP.Their clinical data were compared to those of patients with MPP within the first week.The t test,chi squared test,and Mann-Whitney U test identified 14 independent factors,and logistic regression analysis was used to screen potential early clinical predictors in the RMPP group.Results Among 93 cases of MPP,the incidence of RMPP was 25.8%(24/93).There were significant differences in age,as well as lactate dehydrogenase and D-dimer levels in the blood within the first week between the RMPP and general MPP groups(P<0.05).Multivariate logistic regression analyses demonstrated that age(OR=1.277,P=0.027)and blood lactate dehydrogenase(OR=1.047,P=0.001)and D-dimer levels within the first week(OR=1.243,P=0.004)affected RMPP.Conclusion Age and levels of lactate dehydrogenase and D-dimer in the blood within the first week may be early clinical factors predictive of RMPP in children.

关 键 词：儿童 肺炎 难治性肺炎支原体 因素 

分 类 号：R725.6[医药卫生—儿科]