摘要
目的基于支原体感染时间和滴度对肺炎支原体肺炎(MPP)患儿并发大叶性肺炎进行风险预测。方法选取2021年11月至2024年11月我院收治103例的MPP患儿,根据是否并发大叶性肺炎分为发生组(n=32)和未发生组(n=71)两组。比较两组一般资料、血清生物学指标和支原体滴度,对差异显著的因素进行多因素分析,并根据支原体感染时间和滴度对肺炎支原体肺炎患儿并发大叶性肺炎绘制受试者工作特征(ROC),对其进行风险预测。结果发生组发病到使用大环内酯类药物时间、中性粒细胞百分比、C-反应蛋白(CRP)、乳酸脱氢酶(LDH)水平、支原体感染时间及支原体滴度≥1∶160占比均高于未发生组(P<0.05);多因素Logistic回归分析结果显示,以上6个因素均为肺炎支原体肺炎患儿并发大叶性肺炎的影响因素(P<0.05);支原体感染时间和支原体滴度单独预测并发大叶性肺炎的ROC曲线下面积AUC分别为0.888(95%CI:0.810~0.941)和0.840(95%CI:0.754~0.904),灵敏度分别为85.29%和85.29%,约登指数分别为0.708和0.679。联合预测的AUC、灵敏度、特异性和约登指数分别为0.939(95%CI:0.875~0.977)、91.18%、86.96%和0.781。结论发病到使用大环内酯类药物时间、中性粒细胞百分比、CRP、LDH水平、支原体感染时间及支原体滴度均为肺炎支原体肺炎患儿并发大叶性肺炎的危险因素,可基于支原体感染时间和滴度可对其进行风险预测,且联合预测效果更好。
Objective To predict the risk of children with M.pneumoniae pneumonia(MPP)based on the time and titer of mycoplasma infection.Methods A total of 103 MPP children from November 2021 to November 2024 were selected as study subjects and divided into occurrence(n=32)and no occurrence(n=71)according to lobar pneumonia.Compared the general data,serological indexes and mycoplasma titer,conducted multivariate Logistic regression analysis of the statistically significant indicators,and calculated the subject working characteristics(ROC)of children with m pneumoniae pneumonia complicated with lobar pneumonia according to mycoplasma infection time and mycoplasma titer,making risk prediction.Results The time from onset to use of macrolide drugs,percentage of neutrophils,C-reactive protein(CRP),lactate dehydrogenase(LDH)level,time of mycoplasma infection and mycoplasma titer 1:160 were all higher than the untreated group(P<0.05);after multivariate Logistic regression analysis,All the above 6 factors are the influencing factors of mycoplasma pneumoniae children complicated with lobar pneumonia(P<0.05);the ROC area under the curve AUC of mycoplasma infection time and mycoplasma titer alone predicted concurrent lobar pneumonia were 0.888(95%CI:0.810~0.941)and 0.840(95%CI:0.754~0.904),respectively,sensitivity was 85.29%and 85.29%,respectively.The Youden index was 0.708 and 0.679,respectively.The AUC,sensitivity,specificity and Youden index of the combined prediction were 0.939(95%CI:0.875~0.977),91.18%,86.96%and 0.781,respectively.Conclusion The onset to use of macrolide,percentage of neutrophils,CRP,LDH level,time of mycoplasma infection,and mycoplasma titer were all risk factors for children with mycoplasma pneumonia,mycoplasma infection time and titer for risk prediction,and the combined prediction effect was better.
作者
许亚丽
石宏
周显一
XU Ya-li;SHI Hong;ZHOU Xian-yi(Department of Pediatrics,Kaifeng Central Hospital,Kaifeng 475000,Henan Province,China)
出处
《罕少疾病杂志》
2025年第12期50-53,共4页
Journal of Rare and Uncommon Diseases
基金
河南医学科技攻关计划联合共建项目(LHGJ20201261)。
关键词
肺炎支原体肺炎
大叶性肺炎
支原体感染时间
支原体滴度
Mycoplasma Pneumoniae Pneumonia
Lobar Pneumonia
Time of Mycoplasma Infection
Mycoplasma Titer
