摘要
目的:探讨儿童肺炎支原体肺炎(MPP)急性期高分辨率CT(HRCT)特征与血清炎症因子、病情严重程度及预后的相关性。方法:选取130例急性期MPP患儿作为研究对象,均行HRCT检查,测定患儿的血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-10(IL-10)水平,根据临床肺部感染评分评估MPP患儿的病情严重程度。患儿好转出院后进行为期1年的定期门诊随访,观察有无肺部后遗症发生,剔除失访患儿。结果:MPP患儿主要表现为不均匀性肺实变影(82.31%)、支气管壁增厚(70.77%)、支气管充气征(51.54%)、淋巴结肿大(22.31%)和胸腔积液(20.00%)。大叶性实变影MPP患儿的血清CRP、TNF-α和IL-10水平显著高于节段性实变影和小叶性实变影患儿(P均<0.05),节段性实变影患儿的血清CRP、TNF-α和IL-10水平显著高于小叶性实变影患儿(P均<0.05)。重症组中大叶性实变影的比例显著高于节段性实变影和小叶性实变影患儿所占比例(P<0.05)。共112例MPP患儿完成全程随访,其中17例存在肺部后遗症,有肺部后遗症组与无后遗症组在淋巴结肿大、支气管充气征及肺实变影类型方面差异有统计学意义(P<0.05)。二元Logistic回归分析结果显示,出现支气管充气征和实变影增大是MPP患儿发生肺部后遗症的独立危险因素(P均<0.05)。结论:MPP患儿的HRCT特征与血清炎症因子水平、病情严重程度和预后具有一定相关性,可为临床诊治提供参考依据。
Objective:To investigate the correlation between the characteristics of high-resolution CT(HRCT)and serum inflammatory factors,disease severity,and prognosis of Mycoplasma pneumoniae pneumonia(MPP)in children at the acute stage.Methods:A total of 130 children with acute MPP were selected as the study subjects,all of whom underwent HRCT examination,and the levels of serum C reactive protein(CRP),tumor necrosis factor-alpha(TNF-α),and interleukin-10(IL-10)were measured.The severity of MPP was evaluated according to the clinical pulmonary infection score.All the children were followed up regularly for one year after discharge from the hospital to observe whether pulmonary sequelae occurred,and the children lost to follow-up were excluded.Results:The main manifestations of MPP children were heterogeneous lung consolidation(82.31%),bronchial wall thickening(70.77%),air bronchogram(51.54%),lymphadenopathy(22.31%),and pleural effusion(20.00%).The serum levels of CRP,TNF-α,and IL-10 in children with lobar consolidation were significantly higher than those in children with segmental consolidation and lobular consolidation(all P<0.05),and the serum levels of CRP,TNF-α,and IL-10 in children with segmental consolidation were significantly higher than those in children with lobular consolidation(all P<0.05).The proportion of large lobar consolidation in the severe group was significantly higher than that of segmental and lobular consolidation(P<0.05).A total of 112 MPP children were followed up throughout the entire process,of which 17 cases had pulmonary sequelae.There were statistically significant differences in lymphadenopathy,air bronchogram,and lung consolidation type between the group with pulmonary sequelae and the group without sequelae(P<0.05).Binary Logistic regression analysis showed that air bronchogram and increased consolidation were independent risk factors for pulmonary sequelae in children with MPP(all P<0.05).Conclusion:The HRCT characteristics of MPP children are correlated with the levels of serum inflammatory factors,disease severity,and prognosis,which can provide a reference for clinical diagnosis and treatment.
作者
苏布德格日乐
刘伟民
斯琴格日勒
吉木斯古楞
宝高娃
吴春霞
SuBuDeGeRiLe;Liu Wei-min;SiQinGeRiLe(Combination of Mongolian and Western Medicine with Pediatrics,Affiliated Hospital of Inner Mongolia University for The Nationalities,Neimeng 028000,China)
出处
《放射学实践》
CSCD
北大核心
2023年第9期1173-1177,共5页
Radiologic Practice
基金
内蒙古自然科学基金(2021MS08140)。
