摘要
目的探讨儿童难治性肺炎支原体肺炎(RMPP)后发生塑型性支气管炎的影响因素。方法回顾性选取2017年1月至2020年12月于我院就诊并行支气管镜检查的100例RMPP患儿为研究对象,收集并分析患儿的一般资料、临床表现、实验室指标、影像学表现、支气管镜下表现。根据支气管镜检查结果对患儿进行分组。通过单因素分析及多因素Logistic回归分析探讨RMPP患儿发生塑型性支气管炎的潜在影响因素。结果100例RMPP患儿中,塑型性支气管炎35例(塑型组),非塑型性支气管炎65例(非塑型组)。塑型组的发热持续时间、住院时间长于非塑型组,呼吸急促、胸腔积液患儿占比、支气管镜灌洗次数、白细胞计数、中性粒细胞比例、C反应蛋白及乳酸脱氢酶水平高于非塑型组,淋巴细胞比例低于非塑型组(P<0.05)。多因素Logistic回归分析显示,发热持续时间、呼吸急促、胸腔积液、白细胞计数、中性粒细胞比例、淋巴细胞比例、C反应蛋白、乳酸脱氢酶为儿童RMPP后发生塑型性支气管炎的独立影响因素(P<0.05),其中发热持续时间、淋巴细胞比例、C反应蛋白、乳酸脱氢酶的临界值分别为10 d、30%、40 mg/L、450 U/L。结论儿童RMPP后发生塑型性支气管炎的影响因素较多,临床尤其应关注患儿的发热持续时间、淋巴细胞比例、C反应蛋白、乳酸脱氢酶水平,及时调整治疗方案,促进患儿尽快康复。
Objective To explore the factors affecting plastic bronchitis after refractory Mycoplasma pneumoniae pneumonia(RMPP)in children.Methods A total of 100 children with RMPP treated in our hospital and examined by bronchoscopy from January 2017 to December 2020 were retrospectively selected as the research objects,and their general data,clinical manifestations,laboratory indexes,imaging manifestations and bronchoscopic manifestations were collected and analyzed.The children were grouped according to the results of bronchoscopy.The potential factors affecting plastic bronchitis in children with RMPP were explored by univariate analysis and multivariate Logistic regression analysis.Results Among 100 children with RMPP,there were 35 cases of plastic bronchitis(plastic group)and 65 cases of non-plastic bronchitis(non-plastic group).The fever duration and hospital stay in the plastic group were longer than those in the non-plastic group,the proportions of children with shortness of breath and pleural effusion,bronchoscopic lavage times,leukocyte count,neutrophil ratio,C-reactive protein and lactate dehydrogenase levels were higher than those in the non-plastic group,and the lymphocytes ratio was lower than that in the non-plastic group(P<0.05).The multivariate Logistic regression analysis showed that fever duration,shortness of breath,pleural effusion,leukocyte count,neutrophil ratio,lymphocyte ratio,C-reactive protein and lactate dehydrogenase were independent influence factors for plastic bronchitis after RMPP(P<0.05).The critical values of fever duration,lymphocyte ratio,C-reactive protein and lactate dehydrogenase were 10 d,30%,40 mg/L and 450 U/L respectively.Conclusion There are many influence factors of plastic bronchitis after RMPP in children.Clinical attention should be paid to the fever duration,lymphocytes ratio,C-reactive protein and lactate dehydrogenase levels,and the treatment plan should be adjusted in time to promote the recovery of children as soon as possible.
作者
索静宇
辛丽红
康媛洁
SUO Jingyu;XIN Lihong;KANG Yuanjie(No.2 Respiratory Department,Xi'an Children's Hospital,Xi'an 710003,China)
出处
《临床医学研究与实践》
2021年第28期36-39,共4页
Clinical Research and Practice
基金
陕西省重点研发计划项目(一般项目-社会发展领域)(No.2018SF-242)。
关键词
难治性肺炎支原体肺炎
儿童
塑型性支气管炎
refractory Mycoplasma pneumoniae pneumonia
children
plastic bronchitis
