儿童肺炎支原体肺炎临床特点及重症危险因素分析

目的:了解住院儿童肺炎支原体肺炎(MPP)的流行病学及临床特点，并分析儿童重症MPP的相关因素。方法: 收集2017年1月-2017年12月于天津医科大学第二医院儿科住院治疗的MPP患儿180例，进行回顾性分析。按病情严重程度分为重症组（SMPP组）73例、普通组（MPP组）107例进行比较，分析流行病学、临床特点以及SMPP相关因素。结果:（1）儿童MPP多以秋（84例，46.7%）、冬（56例，31.1%）季节为主。（2）SMPP组与MPP组比较，前者患病年龄大，发热时间长，影像学多表现为大片状实变影，住院时间偏长。（3）SMPP组与MPP组比较降钙素原（PCT）无差异，而外周血白细胞计数（WBC）、C-反应蛋白（CRP）、血清IgA、血清IgG、血清IgM、乳酸脱氢酶（LDH）和铁蛋白（SF）指标明显高于MPP组，差异有显著性。（4）二分类Logistic回归分析发现热程（OR=1.30，P=0.031）、CRP（OR=1.06，P=0.005）、LDH（OR=1.012，P= 0.001）及胸片大片状实变影（OR=11.57，P=0.000）共4个自变量为SMPP的独立相关因素。结论:儿童MPP多发生在秋冬季。SMPP多发生在学龄期，胸部影像学检查多表现为大片状实变影，WBC、CRP、LDH及SF等炎症指标升高明显，其中热程、CRP、LDH及影像学显示大片状实变影与病情严重程度有关。

Clinical characteristics and risk factors for mycoplasma pneumoniae pneumonia in children

Objective: To investigate the epidemiological and clinical features of hospitalized children with Mycoplasma pneumoniae pneumonia(MPP), and to analyze the related factors for severe MPP in children. Methods: A total of 180 children with MPP who were hospitalized in the pediatrics of Tianjin Medical University from January 2017 to December 2017 were retrospectively analyzed. According to the severity of the disease, 73 patients in the severe group (SMPP group) and 107 patients in the general group (MPP group) were compared to analyze epidemiological, clinical features and SMPP related factors. Results:（1）Children’s MPP was mainly in autumn (84 cases, 46.7%) and winter(56 cases, 31.1%). （2）Compared with the MPP group, the SMPP group had a older age and a longer fever time, and the imaging showed a large-scale solid-like change, and the hospitalization time was also longer. （3）There was no difference in procalcitonin(PCT) between the SMPP group and the MPP group, but peripheral blood leukocyte count(WBC), C-reactive protein(CRP), serum IgA, serum IgG, serum IgM, lactate dehydrogenase (LDH) and ferritin (SF) indicators were significantly higher than those in the MPP group. （4）Two-class logistic regression analysis found that the thermal path (OR=1.30, P=0.031), CRP(OR=1.06, P=0.005), LDH (OR=1.012, P=0.001) and the large slice of the chest radiograph(OR=11.57, P=0.000). A total of 4 independent variables are related independent factors for SMPP. Conclusion: MPP in Children occurs mostly in autumn and winter. SMPP occurs mostly at school age, and chest imaging examinations often show large-scale solid changes. The inflammatory indexes such as WBC, CRP, LDH and SF increase significantly in SMPP. And the heat history, CRP, LDH and the large slice of the chest radiograph may be related to the severity of the condition.