摘要
目的探讨小儿危重病例评分与重症肺炎支原体肺炎患儿临床特征及血清学指标的关系。方法选取2015年4月1日-2017年4月30日期间某院收治的重症肺炎支原体肺炎患儿60例为研究对象,按照PICS评分差异,分为非危重组、危重组、极危重组,统计并比较各组患者的一般资料、临床特征及血清炎症介质和凝血指标水平。结果三组患者病程>12天、异常ECG、合并2种及以上病原感染、合并2个及以上系统损害患者比例间差异有统计学意义(P<0.05);三组患者PLT、D二聚体、可溶性P选择素、CRP、IL-6、PA水平间差异有统计学意义(P<0.05);有序回归分析发现,合并2种及以上病原感染、D二聚体、可溶性P选择素、IL-6与PICS评分呈现正相关性,PLT、PA与PICS评分呈现负相关性(P<0.05);随着治疗时间延续,患者病情好转,PICS评分升高。结论儿童危重病例评分可有效反映重症肺炎支原体肺炎患儿的临床特征、凝血功能及炎症反应程度,其动态评分可用于疾病进展的评估。
Objectives To explore the relationship between pediatric critical iuness score and the clinical features and serologic indexes of patients with severe mycoplasma pneumonia. Methods 60 cases of severe mycoplasma pneumonia admitted by a hospital between April 1 st, 2015 and April 30 th, 2017 were selected as subjects. According to the differences in PICS scores, the children were divided into non-critical group, critical group and extremely critical group. Results There were statistically significant differences in the proportion of patients over 12 days, abnormal ECG, combined with 2 or more pathogenic infections, combined with 2 or more system damage（P〈0.05）. There were statistically significant differences between the three groups in the levels of PLT, D dimer, soluble P selectin, CRP, il-6 and PA（P〈0.05）. According to the sequential regression analysis, the combination of 2 or more pathogenic infections, D dimer, soluble P selectin, il-6 and the PICS score showed positive correlation, and the PLT, PA and the PICS score showed negative correlation（P〈0.05）. With the duration of treatment, the patient＇s condition improved and the PICS score increased. Conclusions The score of critical cases in children could reflect the clinical features, coagulation function and inflammatory response of mycoplasma pneumoniae children effectively, and the dynamic score could be used to evaluate the disease progression.
作者
范秀玖
梁菊芳
张荣贵
肖毅
Fan Xiujiu;Liang Jufang;Zhang Ronggui;Xiao Yi(Department of Pediatric,Shenzhen Shajing People＇s Hospital Affiliated to Guangzhou Medical University,Shenzhen 518104,China)
出处
《中国病案》
2018年第10期95-98,共4页
Chinese Medical Record
关键词
儿童危重病例评分
重症肺炎支原体肺炎
临床特征
凝血指标
炎性因子
Children critical case score
Severe mycoplasma pneumonia
Clinical features
Coagulation index
Inflammatory cytokines
