摘要
目的寻找并分析儿童重症肺炎支原体肺炎(MPP)急性期的相关因素,以协助临床早期认识,及时治疗。方法回顾性分析北京儿童医院呼吸科病房2009年1月-2010年1月101例重症MPP患儿(重症组)和102例轻症MPP患儿(对照组)的住院病历资料,分析比较2组间的发病年龄、性别、病变部位、大环内酯类药物应用开始时间及WBC、N、PLT、CRP、ESR、LDH、纤维蛋白原(FIB)和D-二聚体等实验室指标,对单因素分析后有统计学意义的指标进行成组Logistic回归分析,寻找重症MPP急性期的独立相关因素,并对所得相关因素作ROC曲线,寻找其诊断临界值。结果经单因素分析及成组Logistic回归分析后,发现患儿发病年龄(OR=0.980,P=0.026)、大环内酯类药物应用开始时间(OR=1.346,P=0.000)、CRP水平(OR=1.063,P=0.000)、ESR水平(OR=1.030,P=0.028)及LDH水平(OR=1.016,P=0.000)共5个自变量为重症MPP急性期的独立相关因素,其诊断临界值分别为9.46岁、6.5 d、36.0 mg.L-1、47.6 mm.(1 h)-1、250 IU.L-1,以CRP临界值的诊断准确度最高,LDH次之。结论年龄(>9.46岁)是重症MPP发生的保护性因素,而大环内酯类药物应用开始时间的延迟及CRP、ESR和LDH水平的升高则可提示重症MPP发生的可能,其中以CRP临界值的判断准确度最高。
Objective To investigate and analyze the relevant factors of severe mycoplasma pneumoniae pneumonia（MPP） in the acute phase in children,so as to recognize and treat the disease earlier.Methods A retrospective study of children with MPP was performed in 101 severe cases（severe group） and 102 mild cases（control group） in Department of Respiratory,Beijing Children′s Hospital from Jan.2009 to Jan.2010.The univariate comparisons of the 2 groups including age,gender,site of lesion in lobes,time of reception effective antibiotics,white blood cells,neutrophile granulocyte ratio,platelet,C-reactive protein（CRP）,erythrocyte sedimentation rate（ESR）,lactate dehydrogenase（LDH）,fibrinogen,D-dimer were carried out.Then,the binary Logistic regression analysis was used to identify factors which were significantly associated with severe MPP independently,and receiver operating characteristic curve analysis was performed to find out the cut-off value for the significant relevant factors.Results After adjustment by univariate comparisons and the binary Logistic regression analysis,5 fa-ctors were independently associated with severe MPP,which were age（OR=0.980,P=0.026）,time of reception effective antibiotics（OR=1.346,P=0.000）,the level of CRP（OR=1.063,P=0.000）,the level of ESR（OR=1.030,P=0.028） and the level of LDH（OR=1.016,P=0.000）.The cut-off values of those independent relevant factors above were 9.46 years,6.5 d,36.0 mg·L^-1,47.6 mm·（1 h）^-1 and 250 IU·L^-1 respectively,and the cut-off value of CRP had the highest diagnostic accuracy,LDH was the next.Conclusions Age（9.46 years） is a protective factor for severe MPP,and time of reception effective antibiotics,the levels of CRP,ESR and LDH may indicate the possibility of severe MPP,and the cut-off value of CRP has the highest diagnostic accuracy.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2011年第4期246-249,共4页
Journal of Applied Clinical Pediatrics
作者简介
俞珍惜，女，住院医师，硕士学位，研究方向为呼吸系统疾病，电子信箱yuzx05@163．com。
通讯作者：刘秀云，女，主任医师，博士学位，研究方向为呼吸系统疾病，电子信箱liu-xiuyun@sohu．com
