小儿支原体肺炎合并胸腔积液的影响因素探究  

Influencing factors of mycoplasmal pneumonia complicated with pleural effusion in children

作　　者：汪丹阳 陈妍[1] WANG Danyang;CHEN Yan(Department of Pediatrics,Jinhua People’s Hospital,Jinhua 321000,Zhejiang,China)

机构地区：[1]金华市人民医院儿科,浙江金华321000

出　　处：《中国现代医生》2024年第31期47-50,75,共5页China Modern Doctor

摘　　要：目的探讨小儿支原体肺炎(mycoplasmal pneumonia,MPP)合并胸腔积液的影响因素。方法选取2021年1月至2023年11月金华市人民医院收治的168例MPP患儿,根据影像学结果将其分为无胸腔积液组(115例)和胸腔积液组(53例)。收集患儿的基本信息、实验室指标及胸部影像学检查结果,采用多因素Logistic回归分析探究MPP患儿并发胸腔积液的影响因素,绘制受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析实验室指标的诊断效能。结果胸腔积液组患儿的血小板计数、白细胞介素(interleukin,IL)-10、IL-4均显著低于无胸腔积液组,C反应蛋白(C-reactiveprotein,CRP)、降钙素原、乳酸脱氢酶、D-二聚体、糖胺聚糖(glycosaminoglycan,GAG)、IL-17、γ干扰素(interferon-γ,IFN-γ)均显著高于无胸腔积液组(P<0.05);多因素Logistic回归分析结果显示CRP、乳酸脱氢酶、D-二聚体、GAG、IL-17、IL-4、IFN-γ均为MPP患儿并发胸腔积液的独立影响因素(P<0.05)。ROC曲线分析结果显示GAG、IFN-γ、D-二聚体、CRP、IL-4、乳酸脱氢酶和IL-17预测MPP患儿并发胸腔积液的曲线下面积分别为0.954、0.824、0.813、0.786、0.765、0.732、0.727,其中血清GAG的敏感度(96.4%)、特异性(93.1%)和准确度(95.4%)最高。结论血清CRP、乳酸脱氢酶、D-二聚体、GAG、IL-17、IL-4和IFN-γ均是MPP患儿并发胸腔积液的独立影响因素,对MPP患儿并发胸腔积液有一定的诊断价值。Objective To investigate the influencing factors of mycoplasmal pneumonia(MPP)with pleural effusion in children.Methods A total of 168 children with MPP admitted to Jinhua People’s Hospital from January 2021 to November 2023 were selected and divided into non-pleural effusion group(115 cases)and pleural effusion group(53 cases)according to imaging results.Basic information,laboratory indicators and chest imaging results were collected.Multivariate Logistic regression analysis was used to explore the influencing factors of pleural effusion in MPP children.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficiency of laboratory indicators.Results The platelet count,interleukin(IL)-10 and IL-4 of children in pleural effusion group were significantly lower than those in non-pleural effusion group,C-reactive protein(CRP),procalcitonin,lactate dehydrogenase,D-dimer,glycosaminoglycan(GAG),IL-17 and interferon-γ(IFN-γ)were significantly higher than those in non-pleural effusion group(P<0.05).Multivariate Logistic regression analysis showed that CRP,lactate dehydrogenase,D-dimer,GAG,IL-17,IL-4 and IFN-γwere independent influencing factors of pleural effusion in MPP children(P<0.05).ROC curve analysis results showed that the areas under the curve of GAG,IFN-γ,D-dimer,CRP,IL-4,lactate dehydrogenase and IL-17 predicting pleural effusion in MPP children were 0.954,0.824,0.813,0.786,0.765,0.732 and 0.727,respectively.The sensitivity(96.4%),specificity(93.1%)and accuracy(95.4%)of serum GAG were the highest.Conclusion Serum CRP,lactate dehydrogenase,D-dimer,GAG,IL-17,IL-4 and IFN-γare all independent influencing factors for pleural effusion in MPP children,and have certain diagnostic value for pleural effusion in MPP children.

关 键 词：支原体肺炎 胸腔积液 影响因素 诊断价值 

分 类 号：R375.2[医药卫生—病原生物学]