摘要
目的 探讨儿童肺炎支原体肺炎（MPP）合并黏液栓的危险因素.方法 回顾性总结分析2013年9月至2016年9月西安市儿童医院收治的行支气管镜检查的149例MPP患儿的临床资料.根据支气管镜结果将患儿分为黏液栓组82例和非黏液栓组67例.通过单因素及多因素分析MPP患儿黏液栓形成的危险因素,绘制独立危险因素ROC曲线,计算AUC,判断各指标的诊断效果.结果 单因素分析结果提示：黏液栓组的年龄（5.88±2.01）岁、合并胸腔积液比例64.63％、总热程（10.65±2.87）d、C反应蛋白（C-rective protein,CRP）（50.99±20.23）mg/L和乳酸脱氢酶（lactate dehydrog enase,LDH）水平（429.94±160.28）U/L均高于非黏液栓组[年龄（5.12±2.15）岁、合并胸腔积液比例28.36％、总热程（8.97±3.01）d、CRP（20.89±9.98）mg/L和LDH水平（300.12±125.14）U/L],差异有统计学意义（P均〈0.05）.多因素分析提示：年龄大、热程长、CRP及LDH高是独立危险因素,95％CI分别为2.054～18.305、1.539～21.778、1.159～24.565、1.883～9.469,P均〈0.05）.ROC曲线分析显示CRP、LDH的AUC分别为0.897、0.829.结论 年龄大、热程长、CRP及LDH高是MPP患儿黏液栓形成的独立危险因素,且CRP的诊断价值高于LDH,通过监测上述指标帮助临床医师判断患者是否需要及时行支气管镜检查,从而预防黏液栓的形成,改善预后.
Objective To explore the risk factors of Mycoplasma pneumoniae pneumonia （ MPP ） combined with mucous plug in children. Methods A retrospective analysis was carried out on the clinical data of one hundred and forty-nine patients with MMP who received fiber bronchoscope from September 2013 to September 2016. Based on the airway mucosal lesions seen through the bronchoscope,patients were divided into two groups：the mucous plug group（ 82 cases） and the control group（ 67 cases） . The risk factors of mucous plug in MMP children were analyzed through single factor and multifactor analysis. Area under curve （ AUC ） was calculated according to receiver operator characteristic （ ROC ） curve to evaluate the diagnostic value of independent risk factor. Results The result of univariate analysis showed that,in the mucous plug group,the age was （5.88±2.01）ages,pleural effusion cases was 64.63%,febrile course was （10.65±2.87）d,CRP was （50. 99±20. 23） mg/L,serum LDH was （429. 94±160. 28）U/L,significantly higher than those in the control group （ age（5. 12±2. 15）ages,pleural effusion cases was 28. 36%,febrile course was（8. 97±3. 01）d,CRP was （20. 89±9. 98） mg/L and serum LDH was（300. 12±125. 14）U/L）,the differences were statistically significant （P〈0. 05） . Multiple factors analysis showed that age of onset, febrile course, CRP, serum LDH were the independent risk factors, the differences were statistically significant （ 95%CI= 2. 054 ～ 18. 305, 1. 539 ～21. 778,1. 159 ～ 24. 565,1. 883 ～ 9. 469,P〈0. 05） . . ROC curve analysis indicated that the AUC of CRP and LDH was 0. 897,0. 829,respectively. Conclusion Old age,long febrile course,and high level of CRP and LDH are the independent risk factors for the mucous plug formation in MPP children. The diagnostic value of CRP is higher than that of LDH. Monitoring these factors can help the doctor determine whether the patient need do bronchoscope without delay and prevent the formation of mucous plug and improve the prognosis.
作者
陈伟民
张涛
徐嫚
李志娟
Chen Weimin;Zhang Tao;Xu Man;Li Zhijuan(Department of respiratory,southern district of Xi＇an Children＇s Hospital,Xi＇an 710003)
出处
《中国综合临床》
2018年第6期545-548,共4页
Clinical Medicine of China
关键词
儿童
肺炎支原体肺炎
黏液栓
危险因素
Children
Mycoplasma Pneumoniae Pneumonia
Mucous Plug
Risk Factor
