摘要
目的探讨支气管肺泡灌洗液(BALF)中乳酸(LA)水平与难治性肺炎支原体肺炎(RMPP)患儿病情及预后的关系。方法选取2023年1月—2024年6月秦皇岛市妇幼保健院儿科收治的RMPP患儿50例为RMPP组,普通肺炎支原体肺炎(MPP)患儿50例为MPP组。比较两组BALF中LA水平。根据病情严重程度[采用临床肺部感染评分(CPIS)评估],将RMPP组患儿进一步分为轻症亚组(CPIS<5分,28例)和重症亚组(CPIS≥6分,22例)。根据预后,将RMPP组患儿进一步分为预后良好亚组(35例)和预后不良亚组(15例)。采用Pearson相关分析探讨RMPP组BALF中LA水平与CPIS的关系;采用多因素Logistic回归分析探讨RMPP患儿预后不良的影响因素;采用ROC曲线分析BALF中LA水平对RMPP患儿预后不良的预测价值。结果RMPP组BALF中LA水平高于MPP组(P<0.05)。重症亚组BALF中LA水平高于轻症亚组(P<0.05)。Pearson相关分析结果显示,RMPP组BALF中LA水平与CPIS呈正相关(P<0.05)。预后不良亚组病程、发热时间长于预后良好亚组,最高体温、BALF中LA水平高于预后良好亚组(P<0.05)。多因素Logistic回归分析结果显示,病程、发热时间、最高体温、BALF中LA水平是RMPP患儿预后不良的影响因素(P<0.05)。ROC曲线分析结果显示,BALF中LA水平预测RMPP患儿预后不良的AUC为0.833[95%CI(0.715~0.894)],最佳截断值为1.6mmol/L,灵敏度为69.44%,特异度为88.29%。结论RMPP患儿BALF中LA水平升高,其与患儿病情严重程度呈正相关,是患儿预后不良的影响因素,且对患儿预后不良有一定预测价值。
Objective To investigate the relationship between lactic acid(LA)levels in bronchoalveolar lavage fluid(BALF)and the condition and prognosis of children with refractory mycoplasma pneumoniae pneumonia(RMPP).Methods Fifty children with RMPP admitted to the Department of Pediatrics of Maternity&Child Care Center of Qinhuangdao from January 2023 to June 2024 were selected as the RMPP group,and 50 children with common mycoplasma pneumoniae pneumonia(MPP)were selected as the MPP group.The levels of LA in BALF were compared between the two groups.According to the severity of the disease[evaluated by Clinical Pulmonary Infection Score(CPIS)],the children in the RMPP group were further divided into the mild subgroup(CPIS<5 points,28 cases)and the severe subgroup(CPIS≥6 points,22 cases).According to the prognosis,the children in the RMPP group were further divided into the good prognosis subgroup(35 cases)and the poor prognosis subgroup(15 cases).Pearson correlation analysis was used to explore the relationship between LA level in BALF and CPIS in the RMPP group.Multivariate Logistic regression analysis was used to explore the influencing factors of poor prognosis in children with RMPP.ROC curve was used to analyze the predictive value of LA level in BALF for poor prognosis in children with RMPP.Results The level of LA in BALF in the RMPP group was higher than that in the MPP group(P<0.05).The level of LA in BALF in the severe subgroup was higher than that in the mild subgroup(P<0.05).The results of Pearson correlation analysis showed that the level of LA in BALF of the RMPP group was positively correlated with CPIS(P<0.05).The disease course and fever duration in the poor prognosis subgroup were longer than those in the good prognosis subgroup,the highest body temperature and the level of LA in BALF were higher than those in the good prognosis subgroup(P<0.05).The results of multivariate Logistic regression analysis showed that the disease course,fever duration,highest body temperature,and the level of LA in BALF were influencing factors of poor prognosis in children with RMPP(P<0.05).The results of ROC curve analysis showed that the AUC of LA level in BALF for predicting poor prognosis in children with RMPP was 0.833[95%CI(0.715-0.894)],the optimal cut-off value was 1.6 mmol/L,the sensitivity was 69.44%,and the specificity was 88.29%.Conclusion The level of LA in BALF of children with RMPP is elevated,which is positively correlated with the severity of the disease in the children.It is an influencing factor for the poor prognosis of the children and has certain predictive value for the poor prognosis of the children.
作者
高凤
郭静波
洪爽
田大伟
杨召川
GAO Feng;GUO Jingbo;HONG Shuang;TIAN Dawei;YANG Zhaochuan(Department of Pediatrics,Maternity&Child Care Center of Qinhuangdao,Qinhuangdao 066000,China;Department of Child Health,Children's Medical Center,the Affiliated Hospital of Qingdao University,Qingdao 266003,China)
出处
《实用心脑肺血管病杂志》
2025年第8期69-73,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
秦皇岛市科学技术研究与发展计划自筹经费项目(202301A242)。
关键词
肺炎
支原体
难治性肺炎支原体肺炎
儿童
支气管肺泡灌洗液
乳酸
病人病情
预后
Pneumonia,mycoplasma
Refractory mycoplasma pneumoniae pneumonia
Child
Bronchoalveolar lavage fluid
Lactic acid
Patient acuity
Prognosis
