摘要
目的探讨肺炎支原体肺炎（MPP）患儿气道黏液栓形成的危险因素。方法回顾性分析2012年5月至2014年1月收治的行纤维支气管镜治疗的116例MPP患儿的临床资料。根据患儿纤维支气管镜下黏膜损害情况分为黏液栓组（67例）和对照组（49例）,对两组患儿的性别、发病年龄、热程、有无胸腔积液、血常规白细胞计数及中性粒细胞比例、C反应蛋白（CRP）、乳酸脱氢酶（LDH）、发病后开始使用大环内酯类药物时间、首次行纤维支气管镜时间等,进行单因素分析及logistic回归分析;绘制受试者工作特征（ROC）曲线,评价logistic回归模型的预测能力。结果单因素分析结果显示,黏液栓组的年龄、总热程、CRP和LDH水平、合并胸腔积液比例均高于对照组,差异有统计学意义（P均〈0.05）。logistic回归分析显示,年龄≥3岁（OR=7.45,95%CI：1.52-36.71）,热程≥10 d（OR=4.01,95%CI：1.58-10.20）,CRP≥40 mg/L（OR=5.41,95%CI：1.87-15.67）和LDH≥350 U/L（OR=3.63,95%CI：1.35-9.75）是MPP患儿气道黏液栓形成的独立危险因素;ROC曲线下面积（AUC）为0.846（95%CI：0.773-0.919,P=0.000）。结论当MPP患儿年龄≥3岁、热程≥10 d、CRP≥40 mg/L、LDH≥350 U/L时,有气道内黏液栓形成的可能。
Objective To analyze the risk factors of mucous plug caused by Mycoplasma pneumoniae pneumonia（MPP） in children and guide clinical therapy to decrease the incidence of sequela caused by airway inflammatory obstruction. Methods We conducted a retrospective study of the clinical data of 116 children with MPP who received fiber bronchoscope from January 2012 to January 2014 admitted to the respiratory department of the Children＇s Hospital of Hebei provience. Based on the airway mucosal lesions seen through the bronchoscope, the subjects were divided into the mucous plug group（n=67） and the control group（n=49）. Gender, age of onset, febrile course, pleural effusion, white blood cell counts, neutrophil ratio, C reactive protein（CRP）, serum lactate dehydrogenase level（LDH）, initial time of received macrolides and fiber bronchoscope were compared between the two groups. If the results of single factor analysis showed P〈0.05, the indicators were analyzed by the logistic regression analysis. The receiver operator characteristic（ROC） curve was drawn to evaluate the predictability of logistic regression model. Results The results of single factor analysis showed that age of onset, febrile course, CRP, serum LDH, pleural effusion cases in the mucous plug group were higher than those in control group（P〈0.05）. The results of the logistic regression analysis showed that older than three years（OR=7.45）, febrile course more than 10 days（OR=4.01）, the level of CRP and LDH higher than 40 mg/L（OR=5.41） and 350 U/L（OR=3.63） were respectively the risk factors of mucous plug caused by MPP in children. The area under the ROC curve is 0.846（95%CI： 0.773-0.919, P=0.000）. Conclusions MPP children with age older than three years, or with febrile course more than 10 days, or with the level of CRP and LDH higher than 40 mg/L and 350 U/L has the possibility of forming a mucous plug.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2015年第5期432-436,共5页
Journal of Clinical Pediatrics
基金
河北省医学适用技术跟踪项目(No.GL 2010-07)
关键词
肺炎支原体肺炎
黏液栓
危险因素
儿童
Mycoplasmapneumoniae pneumonia
mucous plug
risk factor
child
