摘要
目的探索肺炎支原体肺炎患儿发生胸腔积液的相关因素。方法收集河北省人民医院儿科2016年10月至2020年2月因肺炎支原体肺炎住院的患儿,根据是否发生胸腔积液分为胸腔积液组及非胸腔积液组。比较两组患儿的一般情况及相关检查结果,对单因素分析中差异有统计学意义的相关指标进一步行多因素Logistic回归分析,并绘制受试者工作特征曲线,评价Logistic回归分析模型的预测能力。结果174例患儿中,胸腔积液组34例,非胸腔积液组140例,两组间性别、年龄比较差异无统计学意义(P<0.05)。单因素分析结果显示,两组患儿在是否发生纵隔淋巴结肿大、C-反应蛋白、降钙素原、乳酸脱氢酶、铁蛋白及D-二聚体差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,纵隔淋巴结肿大、乳酸脱氢酶(>400 U/L)、铁蛋白(>100 ng/mL)、D-二聚体(>1.65 mg/L)为肺炎支原体肺炎患儿发生胸腔积液的独立危险因素(OR=3.850、4.393、4.930、6.790,P<0.05)。受试者工作特征曲线下面积为0.847,具有中等偏上诊断准确度(P<0.001)。结论肺炎支原体肺炎患儿存在纵隔淋巴结肿大,乳酸脱氢酶>400 U/L,血清铁蛋白>100μg/L,D-二聚体>1.65 mg/L时,应高度警惕胸腔积液的发生。
Objective To explore the related factors of pleural effusion in children with Mycoplasma pneumoniae pneumonia.Methods The children with Mycoplasma pneumoniae pneumonia hospitalized in the Department of Pediatrics at Hebei General Hospital from October 2016 to February 2020 were divided into pleural effusion group and non-pleural effusion group according to the occurrence of pleural effusion.The general conditions and related examination results of two groups were compared,and the related indexes were further analyzed by multi-factor Logistic regression analysis,and the receiver operating characteristic curve was drawn to evaluate the predictive ability of Logistic regression model.Results All of 174 children,there were 34 cases in pleural effusion group and 140 cases in non-pleural effusion group.There was no significant difference in sex and age between two groups(P<0.05).Univariate analysis showed significant differences in the presence or absence of mediastinal lymphadenopathy,C-reactive protein,procalcitonin,lactate dehydrogenase,serum ferritin and D-dimer between two groups(P<0.05).Multivariate Logistic regression analysis showed that mediastinal lymphadenopathy,lactate dehydrogenase level(>400 U/L),serum ferritin level(>100 ng/mL)and D-dimer level(>1.65 mg/L)were independent risk factors for pleural effusion in children with Mycoplasma pneumoniae pneumonia(OR=3.850,4.393,4.930,6.790,P<0.05).The area under the receiver operating characteristic curve of Logistic regression model was 0.847,with medium to high diagnostic accuracy(P<0.001).Conclusion When the children with Mycoplasma pneumoniae pneumonia have mediastinal lymphadenopathy,lactate dehydrogenase level>400 U/L,serum ferritin level>100μg/L,D-dimer level>1.65 mg/L,we should be highly alert to the occurrence of pleural effusion.
作者
郝晓静
王丽丽
王佳
程亚颖
Hao Xiaojing;Wang Lili;Wang Jia;Cheng Yaying(Department of Pediatrics,Hebei General Hospital,Shijiazhuang 050000,China)
出处
《中国小儿急救医学》
CAS
2022年第12期977-980,共4页
Chinese Pediatric Emergency Medicine
关键词
肺炎支原体肺炎
胸腔积液
儿童
Mycoplasma pneumoniae pneumonia
Pleural effusion
Children
