儿童肺炎支原体肺炎后遗症临床危险因素分析

Clincal risk factors for children with mycoplasma pneumoniae pneumonia sequelae

摘要:

目的：分析儿童肺炎支原体肺炎（mycoplasma pneumoniae pneumonia，MPP）发生后遗症的临床相关危险因素，为临床早期干预、减少后遗症发生提供参考。方法：回顾性分析重庆医科大学附属儿童医院2007年9月-2010年9月875例MPP住院患儿临床资料，急性期后3个月胸片或肺CT仍存在肺不张、肺实变、支气管扩张等表现者共58例，作为后遗症组，随机选取60例急性期后1个月内胸片或肺CT正常的MPP患儿作为对照组，分析2组患儿年龄、热程、喘息、胸腔积液、肺部病变部位及类型、肺外并发症发生情况，比较2组患儿白细胞、C反应蛋白及开始使用大环内酯类抗生素、丙种球蛋白、糖皮质激素的时间有无差异。结果：热程>10 d、合并中至大量胸腔积液、右上肺病变、肺部大片状阴影、肺外多系统损害等发生率后遗症组显著高于对照组，差异具有统计学意义（P<0.05）。结论：热程>10 d、合并中至大量胸腔积液、右上肺病变、肺部大片状阴影、肺外多系统损害为MPP发生后遗症的临床危险因素。

Abstract:

Objectives：To identify the risk factors for the sequelae in children with mycoplasma pneumonia pneumonia（MPP） and to provide instructions for the clinical therapy to minimize the risks of the sequelae. Methods：Clinical data of 875 children with MPP from September 2007 to September 2010 in the Children’s Hospital，Chongqing Medical University were retrospectively reviewed. Based on the findings of X-ray and/or CT scan，the subjects were divided into two groups：sequelae group（n=58） and control group（n=60）. Comparison was made between the two groups in age，fever course，wheeze，pleural effusion，complications，manifestation of pneumonia on X ray and/or CT scan，white blood cell count and C-reaction protein. Results：Incidences of fever course lasting more than 10 d，large pleural effusion，pneumonia located at the right upper lung，large patchy shadow and multiple system damage out of the lung were significantly higher in sequelae group than in control group（P<0.05）. Conclusions：Long fever course，large pleural effusion，pneumonia located at the right upper lung，large patchy shadow in the lung，multiple system damage out of the lung are the clinical risk factors for sequelae of MPP.