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目的进一步了解难治性肺炎(MMP)支原体肺炎的临床特点,早期识别难治性肺炎支原体肺炎。方法用病例对照的研究方法,回顾性分析住院儿童难治性肺炎支原体肺炎相关因素经卡方,两独立样本t检验和条件Logistic回归分析。结果共收集了128例MPP患儿进入分析。难治性MPP组38例,男18例;普通MPP组90例,男56例。①单因素分析显示,难治性MPP组住院天数显著高于普通MPP组(P均<0.05);发热超过10d(χ~2=27.746)和胸腔积液(χ~2=43.308)与难治性MPP相关(P均<0.05)LDH、ALT、AST和CRP水平难治性MPP组均显著高于普通MPP组(P<0.05)。②选择单因素分析后有统计学意义的临床、实验室指标行逐步Logistic回归分析,发热天数(OR=1.422,95%CI:1.040~1.944)、血清ALT水平(OR=1.141,95%CI:1.024~1.271)和CRP值(OR=1.041,95%CI:1.017~1.065)是难治性MPP的独立相关因素。结论疾病早期存在持续高热、CRP增高、肺外损伤,胸腔积液是进展为难治性MPP的独立相关因素,应早期积极干预,预防并发症的发生。
Objective To further understand the clinical features of refractory pneumonia (MMP) mycoplasma pneumonia and to identify intractable pneumonia mycoplasma pneumonia early. Methods A case-control study was conducted to analyze retrospectively the related factors of in-hospital refractory pneumonia mycoplasma pneumonia by chi-square test and two independent samples t test and conditional Logistic regression analysis. Results A total of 128 MPP children were collected for analysis. In refractory MPP group, 38 cases were male and 18 cases were male. The common MPP group included 90 cases and male 56 cases. ① Univariate analysis showed that the days of hospitalization in refractory MPP group were significantly higher than those in normal MPP group (all P <0.05). Compared with refractory MPV group, the days of fever over 10 days (χ ~ 2 = 27.746) and pleural effusion (χ ~ 2 = 43.308) (All P <0.05). The levels of LDH, ALT, AST and CRP in refractory MPP group were significantly higher than those in normal MPP group (P <0.05). (2) Logistic regression analysis of clinical and laboratory indexes with statistical significance after univariate analysis showed that the number of fever days (OR = 1.422, 95% CI: 1.040-1.944), serum ALT level (OR = 1.141, 95% CI: 1.024-1.271) and CRP (OR = 1.041, 95% CI: 1.017-1.065) were independent correlates of refractory MPP. Conclusions There are persistent high fever, high CRP, extra-pulmonary injury and pleural effusion in the early stage of disease. It is an independent and independent factor that progresses to refractory MPP. Early active intervention should be taken to prevent the occurrence of complications.