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 ›› 2024, Vol. 16 ›› Issue (6): 500-508.doi: 10.3969/j.issn.1674-3865.2024.06.009

• 临床研究 • 上一篇    下一篇

儿童肺炎支原体肺炎合并塑型性支气管炎危险因素的系统评价和Meta分析

罗自豪, 耿刚, 王艳红, 李少军   

  1. 400014 重庆，重庆医科大学2023级儿科学专业研究生（罗自豪，王艳红）；重庆医科大学附属儿童医院呼吸科（耿刚），急诊科（李少军）；国家儿童健康与疾病临床医学研究中心，儿童发育疾病研究教育部重点实验室，儿科学重庆市重点实验室（耿刚，李少军）
  • 收稿日期:2024-05-17 修回日期:2024-06-19 出版日期:2024-12-25 上线日期:2024-12-25
  • 通讯作者: 李少军，E-mail:lishaojun1980@hotmail.com

Risk factors for Mycoplasma pneumoniae pneumonia with plastic bronchitis in children:a systematic review and Meta-analysis

LUO Zihao1,GENG Gang2,WANG Yanhong1,LI Shaojun2   

  1. 1Chongqing Medical University,Chongqing 400014,China； 2Children′s Hospital Affiliated to Chongqing Medical University，Chongqing 400014,China
  • Received:2024-05-17 Revised:2024-06-19 Published:2024-12-25 Online:2024-12-25
  • Contact: LI Shaojun，E-mail:lishaojun1980@hotmail.com

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摘要： 目的:系统评价儿童肺炎支原体肺炎合并塑型性支气管炎的危险因素。方法:计算机检索PubMed、Embase、Web of Science、Cochrane Library、中国生物医学文献数据库（CBM）、中华医学期刊全文数据库、万方数据库、维普网、中国知网，搜集涉及儿童肺炎支原体肺炎合并塑型性支气管炎危险因素的相关研究，检索时限均从建库到2024年2月。采用Stata 18.0和RevMan 5.4软件进行Meta分析。结果:共纳入17个研究，均为病例对照研究，包括4 336例患儿。Meta分析结果显示，热程［OR=4.45，95%CI（3.32~5.96），P<0.001］、C反应蛋白［OR=1.45，95%CI（1.28~1.65），P<0.001］、D-二聚体［OR=2.21，95%CI（1.27~3.85），P=0.005］、中性粒细胞比例［OR=1.47，95%CI（1.17~1.85），P=0.001］、胸腔积液［OR=3.63，95%CI（2.77~4.76），P<0.001］、肺不张［OR=4.03，95%CI（2.46~6.63），P<0.001］、过敏史［OR=3.04，95%CI（2.39~3.78），P<0.001］与儿童肺炎支原体肺炎合并塑型性支气管炎呈正相关，淋巴细胞比例［OR=0.71，95%CI（0.52~0.96，P=0.030）］与之呈负相关，乳酸脱氢酶［OR=1.02，95%CI（1.00~1.03），P=0.020］不是其影响因素。结论:当前证据表明，热程长，C反应蛋白、D-二聚体、中性粒细胞比例升高越明显、淋巴细胞比例减少越明显，合并肺不张、胸腔积液，有过敏史为儿童肺炎支原体肺炎合并塑型性支气管炎的危险因素。

关键词: 肺炎支原体, 塑型性支气管炎, 危险因素, Meta分析, 儿童

Abstract: Objective:To systematically evaluate the risk factors for Mycoplasma pneumoniae pneumonia with plastic bronchitis in children.Methods:Computer retrieval was conducted in PubMed,Embase,Web of Science,Cochrane Library,CBM,Chinese Medical Journal Full-text Database,Wanfang Database,VIP and CNKI to collect related studies on risk factors for Mycoplasma pneumoniae pneumonia with plastic bronchitis in children.The retrieval period was from the establishment of the databases to February 2024.Meta-analysis was performed using Stata 18.0 and RevMan 5.4 software.Results:A total of 17 studies were included,all being case-control studies,involving 4 336 children.The results of Meta-analysis showed that fever duration［OR=4.45,95%CI(3.32-5.96),P<0.001］,C-reactive protein(CRP)［OR=1.45,95%CI(1.28-1.65),P<0.001］,D-dimer［OR=2.21,95%CI(1.27-3.85),P=0.005］,neutrophil ratio(N%)［OR=1.47,95%CI(1.17-1.85),P=0.001］,pleural effusion［OR=3.63,95%CI(2.77-4.76),P<0.001］,atelectasis［OR=4.03,95%CI(2.46-6.63),P<0.001］ and allergy history［OR=3.04,95%CI(2.39-3.78),P<0.001］ were positively correlated with Mycoplasma pneumoniae pneumonia complicated with plastic bronchitis in children,while lymphocyte ratio(L%)［OR=0.71,95%CI(0.52-0.96,P=0.030)］ was negatively correlated with it,and lactate dehydrogenase(LDH)［OR=1.02,95%CI(1.00-1.03),P=0.020］ was not an influencing factor for it.Conclusion:Current evidence shows that the longer the fever duration,the higher the proportion of CRP,D-dimer and neutrophils,and the lower the proportion of lymphocytes;combination with atelectasis,pleural effusion,and allergic history are risk factors for Mycoplasma pneumoniae pneumonia with plastic bronchitis in children.

Key words: Mycoplasma pneumoniae, Plastic bronchitis, Risk factors, Meta-analysis, Child