摘要
目的探讨肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)出现肺外表现的危险因素,以期通过早期干预,减少或避免其发生。方法回顾分析2011年1月—2014年10月我院儿科收治的确诊为MPP 558例的临床资料,根据有无出现肺外表现分为肺外表现组(235例)和无肺外表现组(323例)。收集两组性别、年龄、发热、高热、肺部啰音、血白细胞计数、C反应蛋白、胸片X线病变类型、入院前病程、大环内酯类抗生素使用初始时间等临床资料,并进行单因素分析及多因素Logistic回归分析。结果 558例MPP肺外表现发生率为42.11%,涉及全身多个系统,其中以泌尿系统和心血管系统最为多见,分别占15.41%和7.35%。单因素分析结果提示叶或节段性肺炎、入院前病程、血白细胞计数、C反应蛋白及大环内酯类抗生素使用初始时间5个因素为MPP出现肺外表现的危险因素。多因素Logistic回归分析显示,上述5个因素仍为促使肺外表现发生的危险因素,其OR值分别为3.660、1.278、1.143、0.977、0.652。结论 MPP出现肺外表现临床并不罕见,可涉及全身多个系统。叶或节段性肺炎及入院前病程是促使MPP肺外表现发生的2个较为重要危险因素。
Objective To identify the risk factors of extrapulmonary manifestations in children with mycoplasma pneumoniae pneumonia （ MPP） , in order to reduce or prevent its occurrence through early intervention. Methods The clini-cal data of 558 hospitalized children with MPP from January 2011 to October 2014 were retrospectively reviewed. Based on the findings of extrapulmonary manifestations, the subjects were divided into 2 groups： the extrapulmonary manifestation group （235 cases） and non-extrapulmonary manifestation group （323 cases）. The clinical data included gender, age, fever, hyper-pyrexia, rales, white blood cell count（WBC）, C reaction protein（CRP）, the manifestation of pneumonia on X-ray, the course of disease before admission, the initial time of macrolide antibiotics usage and so on. Single factor analysis and Logistic regression analysis were made in 2 groups. Results In up to 42. 11% of cases, a wide variety of extrapulmonary manifesta-tions occurred, which involved multiple body systems. The most 2 involved systems were urinary system and circulatory sys-tem, accounting for 15. 41% and 7. 35% respectively. Strong univariate associations suggested that some factors increase the risks of the occurrence of extrapulmonary manifestations of MPP： lobar/segmental MPP, the course of disease before admis-sion, WBC, CRP, the initial time of macrolide antibiotics usage. With multiple Logistic regression, independent risk factors of the occurrence of extrapulmonary manifestations of MPP were lobar or segmental MPP （OR=3. 660）, the course of disease before admission （OR=1. 278）, WBC （OR=1. 143）, CRP （OR=0. 977） and the initial time of macrolide antibiotics us-age （OR=0. 652）. Conclusion The extrapulmonary manifestations of MPP are not rare involving multiple body systems. Lobar or segmental MPP and the course of disease before admission are the two most important risk factors of inducing the oc-currence of extrapulmonary manifestations of MPP.
出处
《临床误诊误治》
2015年第8期77-81,共5页
Clinical Misdiagnosis & Mistherapy
关键词
肺炎
支原体
儿童
肺外表现
危险因素
Pneumonia,mycoplasma
Child
Extrapulmonary manifestation
Risk factor
