摘要
目的探讨儿童重症肺炎支原体肺炎(severe Mycoplasma pneumoniae pneumonia,SMPP)发生的影响因素,评估影响因素对SMPP的预测价值,为临床早期识别SMPP提供依据。方法采用回顾性研究方法,筛选185例肺炎支原体肺炎患儿,依据病情严重程度分为重症组71例、轻症组114例。收集2组患儿的一般资料及临床特征、实验室检测指标、肺部影像学资料,对其进行回顾性分析。结果重症组患儿热程、C-反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)、白介素-6(interleukin-6,IL-6)、乳酸脱氢酶(lactate dehydrogenase,LDH)、D-二聚体(D-dimer,D-D)水平及影像学双肺阴影、大片肺实变影、胸腔积液的发生率均高于轻症组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示CRP、LDH、D-D水平增高及影像学大片肺实变影是SMPP的危险因素(P<0.05)。CRP、LDH、D-D水平及影像学大片肺实变影预测SMPP的受试者工作特征(receiver operating characteristic,ROC)曲线下面积分别为0.732、0.810、0.794、0.721,CRP、LDH、D-D水平及大片肺实变影联合预测SMPP的ROC曲线下面积为0.864。结论CRP、LDH、D-D水平增高、影像学大片肺实变影是儿童SMPP的危险因素,且均对SMPP有预测价值,四者联合预测价值更高。
Objective To investigate the influencing factors of severe Mycoplasma pneumoniae pneumonia(SMPP)in children and the predictive value of influencing factors for SMPP,so as to provide evidence for clinical early identification of SMPP.Methods A retrospective study was conducted to screen out 185 children with Mycoplasma pneumoniae pneumonia.According to the severity of the condition,185 children were divided into the severe group(71 cases)and the mild group(114 cases).The general data and clinical characteristics,laboratory examination indicators,and pulmonary imaging data of the children in two groups were collected and analyzed.Results Fever process,C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),lactate dehydrogenase(LDH),D-dimer(D-D)levels,and the incidence of bilateral lung shadows,large areas of lung consolidation,and pleural effusion in imaging were higher in the severe group than that in the mild group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that increased CRP,LDH,D-D levels and large areas of lung consolidation in imaging were risk factors for SMPP(P<0.05).The area under the receiver operating characteristic(ROC)curve of CRP,LDH,D-D levels and large areas of lung consolidation in imaging for predicting SMPP were 0.732,0.810,0.794,0.721,respectively,and the area under the ROC curve of CRP,LDH,D-D levels and large areas of lung consolidation combined for predicting SMPP was 0.864.Conclusion Increased CRP,LDH,D-D levels and large areas of lung consolidation in imaging were risk factors for SMPP in children,and all of them had predictive value for SMPP,and the predictive value of four factors combined was higher.
作者
尉全平
翟洪然
YU Quan-ping;ZHAI Hong-ran(Department of Pediatrics,The Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China;Digestive Endoscopy Center,The Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China)
出处
《河北北方学院学报(自然科学版)》
2025年第12期36-40,共5页
Journal of Hebei North University(Natural Science Edition)
关键词
重症肺炎支原体肺炎
危险因素
预测价值
Severe Mycoplasma pneumoniae pneumonia
Risk factors
Predictive value
