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特应性体质肺炎支原体肺炎患儿临床特征及其病情预测指标

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目的 研究特应性体质肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)患儿的临床特征,并探讨其病情预测指标.方法 选取2019年9月~2022年9月在上海交通大学医学院附属新华医院儿呼吸内科确诊为MPP的患儿250例,根据是否为特应性体质分为特应性组(n=149)和非特应性组(n=101).探究特应性体质儿童MPP的临床特征及其发生重症肺炎支原体肺炎(severe mycoplasma pneumoniae pneumonia,SMPP)的危险因素;采用受试者操作特征(receiver operating characteris-tic,ROC)曲线评价乳酸脱氢酶(lactate dehydrogenase,LDH)、免疫球蛋白 E(immunoglobulin E,IgE)、血清淀粉样蛋白 A(serum am-yloid A,SAA)三者联合检测对特应性体质MPP患儿发生SMPP的预测效能.结果 特应性组MPP患儿咳嗽、喘息症状更明显,肺部哮鸣音、合并胸腔积液且重症肺炎和需要激素治疗的比例、激素治疗天数高于非特应性组,差异均有统计学意义(P<0.05);Logistic回归分析结果显示,血清IgE、SAA、LDH水平是特应性体质MPP患儿发生SMPP的独立危险因素(P<0.05);ROC曲线分析结果显示,IgE、SAA、LDH联合检测可用来预测特应性体质儿童SMPP的发生,其曲线下面积(area under the curve,AUC)为0.881,敏感度为81.0%,特异性为85.00%.结论 特应性体质MPP患儿易出现病情加重且治疗需求较高,血清IgE、SAA、LDH联合检测对特应性体质儿童发生SMPP具有较好的临床预测价值.
Clinical Characteristics of Mycoplasma Pneumoniae Infection and Factors Associated with Co-infections in Children
Objective To analyze the clinical characteristics of mycoplasma pneumoniae pneumonia(MPP)in children with atopic constitution and exploring the predictors of disease conditions.Methods A total of 250 children diagnosed with MPP in the Department of Pediatric Respiratory Medicine,Xinhua Hospital,Shanghai Jiaotong University School of Medicine from September 2019 to September 2022 were selected and divided into atopic group(n=149)and non-atopic group(n=101)according to whether they were atopic,to explore the clinical characteristics of MPP in children with atopic constitution and the risk factors of severe mycoplasma pneumoniae pneu-monia(SMPP).The efficacy of the combined test of lactate dehydrogenase(LDH),immunoglobulin E(IgE)and serum amyloid A(SAA)in predicting the development of SMPP in MPP children with atopic constitution was evaluated by the receiver operating character-istic(ROC)curve.Results Children in the atopic group had more pronounced symptoms of cough,wheezing,nasal congestion,croup,combined pleural effusion with severe pneumonia and the proportion requiring hormone therapy than those in the non-atopic group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that serum IgE,SAA and LDH levels were in-dependent risk factors for the development of SMPP in MPP children with atopic constitution(P<0.05);ROC curve analysis showed that the combined test of IgE,LDH and SAA could be used to predict the development of SMPP in MPP children with atopic constitution,with an area under the curve(AUC)of 0.881,sensitivity of 81.0%,and specificity of 85.0%.Conclusion MPP children with atopic con-stitution are more likely to develop SMPP and require hormone therapy.The combined detection of serum IgE,SAA and LDH can effec-tively predict the occurrence of SMPP in MPP children with atopic constitution.

AtopyMycoplasma pneumoniae pneumoniaIgELDHSerum amyloid A protein

李子鑫、武文祺、杨玲、刘芳

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200093 上海交通大学医学院附属新华医院

400000 重庆医科大学

200080 上海市第四人民医院

特应性 肺炎支原体肺炎 IgE 乳酸脱氢酶 血清淀粉样蛋白A

2024

医学研究杂志
中国医学科学院

医学研究杂志

CSTPCD
影响因子:0.702
ISSN:1673-548X
年,卷(期):2024.53(2)
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