儿童重症肺炎支原体肺炎的影响因素分析-东南大学学报医学版

儿童重症肺炎支原体肺炎的影响因素分析

单位：天津儿童医院儿科, 天津北辰 300202

分类号：R725.6

出版年·卷·期（页码）：2025·44·第一期（127-132）

摘要：

目的:探讨儿童轻症与重症肺炎支原体肺炎(MPP)的临床特征及对导致重症的影响因素进行Logistic回归分析。方法:采用回顾性研究方式,在2022年1月至2024年1月天津儿童医院儿科收治的MPP患儿病例中,以纳入、排除标准筛选后选取300例MPP患儿为研究对象;收集患儿一般资料、实验室检测指标、病情评估结果等。根据病情评估结果将患儿分为轻症组和重症组,观察两组患儿临床体征,对两组患儿一般资料、实验室检测指标等分布情况进行对比;采用Logistic回归分析患儿重症的相关影响因素。结果:300例MPP患儿中,13.00%为重症。轻症患儿临床体征主要为发热、咳嗽,重症患儿则伴随胸腔积液、胸膜增厚、消化道出血等。Logistic回归分析显示,发热持续时间、累及肺叶情况、中性粒细胞、C反应蛋白(CRP)、白细胞介素(IL)-6、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、红细胞沉降率(ESR)、D-二聚体是导致重症MPP的危险因素(OR值分别为1.910、2.930、1.752、2.321、1.885、1.749、1.662、1.846、2.230,均P<0.05),淋巴细胞则为保护因素(OR=0.534, P<0.05)。结论:儿童重症MPP较轻症可表现为伴随胸腔积液等并发症,而导致重症MPP的因素较多,观察患儿长时间发热、炎症因子或心肌酶谱水平变化或有助于早期识别重症MPP,为临床诊疗提供客观依据。

Objective: To investigate the clinical characteristics of mild and severe Mycoplasma pneumoniae pneumonia(MPP) in children and to analyze the influencing factors leading to severe disease using Logistic regression. Methods: A retrospective study was conducted in the pediatric patients with MPP treated in Tianjin Children's Hospital from January 2022 to January 2024, and 300 patients were included after inclusion and exclusion criteria screening. General data, laboratory test indicators, and disease evaluation results of children were collected, and the children were divided into mild and severe groups according to the disease evaluation results. Clinical signs of children in the two groups were observed, and the distribution of general data and laboratory test indicators of children in the two groups was compared. Logistic regression was used to analyze the related influencing factors of severe diseases in children. Results: Among 300 children with MPP, 13.00% were severely ill who were accompanied by pleural effusion, pleural thickening and gastrointestinal hemorrhage, etc., and the clinical signs of those of mildly ill children were mainly fever and cough. The Logistic regression analysis showed that the duration of fever, the involvement of the lung lobes, the neutrophils, the CRP, the IL-6, the LDH, the CK-MB, the ESR, and the D-dimer were risk factors for severe MPP, and the risk factors of severe MPP were further analyzed(OR=1.910, 2.930, 1.752, 2.321, 1.885, 1.749, 1.662, 1.846, 2.230, all P<0.05), while lymphocytes were protective factors(OR=0.534,P<0.05). Conclusion: Severe MPP in children can tend to manifest accompanying complications such as pleural effusion compared to mild cases, and several factors lead to severe MPP, too. Observing the children's prolonged fever, inflammatory factors or changes in cardiac enzyme profile levels may help to recognize severe MPP at an early stage and provide an objective basis for clinical diagnosis and treatment.

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