ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2019, Vol. 11 ›› Issue (2): 144-148.doi: 10.3969/j.issn.1674-3865.2019.02.014

• 临床研究 • 上一篇    下一篇

儿童难治性肺炎支原体肺炎的临床特征及高危因素分析

曲百娜，迟磊，朱紫微，黄燕#br#   

  1. 116000 辽宁 大连，大连市儿童医院内科（曲百娜，迟磊，朱紫微，黄燕）；100000 北京，中国科学院大学医学院（黄燕）
  • 出版日期:2019-04-25 发布日期:2019-05-08
  • 通讯作者: 黄燕，E-mail：13304280868@126.com
  • 作者简介:曲百娜（1990-），女，医学硕士，医师。研究方向：小儿呼吸系统疾病的诊治
  • 基金资助:
    2016年辽宁省科学技术基金项目（201602885）

Analysis of clinical features and risk factor of refractory Mycoplasma pneumoniae pneumonia

QU Baina，CHI Lei，ZHU Ziwei，HUANG Yan.   

  1. Dalian Children's Hospital, Dalian 116000,China
  • Online:2019-04-25 Published:2019-05-08

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摘要：
目的
比较儿童难治性肺炎支原体肺炎(RMPP)与普通肺炎支原体肺炎(GMPP)的临床特征，探讨其发生的高危因素，为RMPP的早期发现、早期诊断、早期干预提供一定的理论依据。
方法
选取2016年10月至2017年9月大连市儿童医院呼吸科收治住院的MPP患儿203例为研究对象，其中RMPP组70例，GMPP组133例。比较两组患儿在临床表现，影像学表现及实验室指标的差异，进一步行多因素回归分析。
结果
RMPP组在发病年龄、发热持续时间、发热峰值、发热间隔、合并发热伴随症状的比例、住院时间及肺外并发症的比例较GMPP组相比，差异均有统计学意义（P<0.01）。RMPP组实验室指标中血清C反应蛋白、乳酸脱氢酶水平显著高于GMPP组，差异均有统计学意义（P<0.01）。两组患儿白细胞计数和血清降钙素原比较差异无统计学意义（P>0.05）。RMPP组影像学特征为大叶性肺炎患儿的比例、合并胸腔积液患儿的比例显著高于GMPP组，支气管肺炎患儿的比例显著低于GMPP组，差异均有统计学意义（P<0.01）。发热持续时间、发热间隔、合并发热伴随症状（畏寒、寒战等）、住院时间为RMPP的高危因素。
结论
发热持续时间、住院时间越长，发热间隔越短以及合并发热伴随症状，患儿RMPP的可能性较大。

关键词: 难治性肺炎支原体肺炎, 临床特征, 儿童

Abstract:
Objective
To analyze the clinical characteristics of refractory Mycoplasma pneumoniae pneumonia(RMPP) and general Mycoplasma pneumoniae pneumonia(GMPP) and investigate its high risk factors in order to provide a certain theoretical basis for early detection, early diagnosis, and early intervention of RMPP.
Methods
A total of 203 MMP children treated in Dalian Children's Hospital from October 2016 and September 2017 were chosen as the subjects, of whom there were 70 cases of RMPP and 133 cases of GMPP. The two groups of children were compared in clinical manifestation, imaging results and laboratory indicators, and the multifactor regression analysis was made.
Results
There was statistical difference between RMPP group and GMPP group in age of onset, fever duration, fever peak value, fever interval, proportion of symptoms complicating fever, length of hospital stay and the proportion of extrapulmonary complications(P<0.01). The level of serum Creactive protein and lactate dehydrogenase(LDH) was significantly higher in RMPP group than in GMPP group(P<0.01). There was no difference in WBC count or serum procalcitonin between the two groups(P>0.05). The proportion of children whose imaging shower to be lobar pneumonia and the proportion of children complicated with pleural effusion were significantly higher in RMPP group than in GMPP group, while the proportion of bronchopneumonia was significantly lower(P<0.01). The high risk factors of RMPP were fever duration, fever interval, symptoms complicating fever(being chilly, chills, etc.) and length of hospital stay.
ConclusionThe longer the fever duration and the length of hospital stay, the shorter the fever interval, and the more symptoms complicating fever, the more probable the children get RMPP.

Key words: Refractory Mycoplasma pneumoniae pneumonia, Clinical features, Children