通讯作者: p>何海玲, 34591675@qq.com

DOI：10.12201/bmr.202505.00038

Analysis of clinical characteristics of severe mycoplasma pneumoniae pneumonia in children

• 摘要：目的 探讨儿童重症肺炎支原体肺炎(SMPP)的临床特点及其相关危险因素。方法 分析2023年10月至2024年3月收治的240例肺炎支原体肺炎(MPP)患儿的临床资料，对SMPP发生的相关危险因素进行多因素Logistic回归分析。绘制ROC曲线，分析各独立危险因素对于SMPP的预测价值。结果 与119例普通肺炎支原体肺炎(GMPP)相比，121例SMPP患儿热程、阿奇霉素疗程、住院时间、糖皮质激素使用时间更长，糖皮质激素比例、局限于单侧肺病变和肺部大片状影比例更高，C反应蛋白、白细胞介素（IL）-6、D-二聚体高于GMPP组，而外周血淋巴细胞计数更低，差异均有统计学意义（P<0.05）。多因素分析结果显示，热程、D-二聚体、IL-6、肺部大片状影是发生SMPP的独立危险因素。ROC曲线显示，热程≥6.5天、D-二聚体≥0.495mg/L、IL-6≥11.05 pg/mL和肺部大片状阴影用于鉴别SMPP和GMPP患儿具有较好价值。结论 发热时间长、D-二聚体和IL-6水平升高、肺部大片状影有助于早期识别SMPP。

  关键词： 肺炎支原体肺炎; 　重症; 　危险因素; 　儿童

   

  Abstract: Abstract: To investigate the clinical features and related risk factors of mycoplasma pneumoniae pneumonia (SMPP) in children.Methods The clinical data of 240 children with Mycoplasma pneumoniae pneumonia (MPP) admitted from October 2023 to March 2024 were analyzed, and multivariate logistic regression analysis was used to analyze the risk factors related to the occurrence of SMPP.The ROC curve was plotted to analyze the predictive value of each independent risk factor for SMPP.Results Compared with 119 cases of general Mycoplasma pneumoniae pneumonia (GMPP), the 121 cases of SMPP had longer durations of fever, azithromycin treatment, hospital stay, and glucocorticoid use, higher proportions of glucocorticoid use, unilateral lung lesions, and large patchy lung shadows, higher levels of C-reactive protein (CRP), interleukin (IL)-6, and D-dimer, and lower peripheral blood lymphocyte counts, with statistically significant differences (P<0.05). The results of multivariate analysis showed that heat range, D-dimer and IL-6 were independent risk factors for the development of SMPP. The ROC curve showed that the heat duration ≥ 6.5 days, D-dimer ≥ 0.495 mg/L, IL-6≥11.05 pg/mL, and large patchy opacities in the lungs were of good value in distinguishing children with SMPP and GMPP. Conclusions Prolonged fever, large patchy lung shadows, and elevated levels of D-dimer and IL-6 are helpful for early identification of SMPP.

  Key words: Mycoplasma pneumoniae; Severe; Risk factors; child

  提交时间：2025-05-26

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2025-03-22	bmr.202505.00038V1	下载

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