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目的分析儿童重症肺炎支原体肺炎特征及相关因素,为临床早期诊断儿童重症肺炎支原体肺炎、评估病情严重程度及预后提供依据。方法回顾性分析2013年5月—2015年5月收治的126例儿童肺炎支原体肺炎患儿的临床资料,其中48例儿童重症肺炎支原体肺炎患儿作为重症组;78例儿童轻症肺炎支原体肺炎患儿作为轻症组。对两组患者的临床特征进行单因素分析,对具有统计学意义的变量进行多因素非条件Logistic回归分析。计量资料采用t检验,计数资料采用χ~2检验,P<0.05为差异有统计学意义。结果多因素非条件Logistic回归分析显示,大环内酯类药物应用延迟(OR=2.074,95%CI为0.607~10.974)、CRP升高(OR=5.882,95%CI为0.463~25.782)、IL-6升高(OR=3.273,95%CI为0.487~18.816)及PCT升高(OR=2.154,95%CI为0.663~23.893)均为儿童重症肺炎支原体肺炎的独立危险因素。结论儿童重症肺炎支原体肺炎患儿存在过度炎症反应,大环内酯类药物应用延迟、CRP、IL-6及PCT升高均可显著增大儿童重症肺炎支原体肺炎的发生风险,有利于评估病情的严重程度、疗效及预后。
Objective To analyze the characteristics and related factors of severe Mycoplasma pneumoniae pneumonia in children and provide basis for early diagnosis of severe Mycoplasma pneumoniae pneumonia in children and evaluate the severity and prognosis of children. Methods The clinical data of 126 children with mycoplasma pneumoniae pneumonia admitted in our hospital from May 2013 to May 2015 were retrospectively reviewed. Among them, 48 children with severe mycoplasma pneumoniae pneumonia were included as severe group; 78 children with mild mycoplasmal pneumoniae pneumonia Children as a mild group. The clinical characteristics of two groups of patients were analyzed by univariate analysis, and statistically significant variables were analyzed by multivariate non-conditional logistic regression analysis. Measurement data using t test, count data using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results The multivariate non-conditional Logistic regression analysis showed that the application of macrolides was delayed (OR = 2.074, 95% CI 0.607-10.974), elevated CRP (OR = 5.882, 95% CI 0.463-25.782), IL -6 (OR = 3.273, 95% CI 0.487-18.816) and PCT (OR = 2.154, 95% CI 0.663-23.893) were all independent risk factors for severe mycoplasma pneumoniae pneumonia in children. Conclusions Children with severe Mycoplasma pneumoniae pneumonia have over-inflammatory reaction, delayed use of macrolides, elevated CRP, IL-6 and PCT can significantly increase the risk of severe Mycoplasma pneumoniae pneumonia in children, Severity, efficacy and prognosis.