Analysis of risk factors and predictive value of refractory mycoplasma pneumoniae pneumonia in children
Objective To analyze the risk factors and predictive value of refractory mycoplasma pneumoniae pneumonia(RMPP)in children.Methods 162 child patients with mycoplasma pneumoniae pneumonia(MPP)were included in this study,in which 44 child patients with RMPP were selected as the RMPP group,and the other 118 child patients with general mycoplasma pneumonia(GMPP)were selected as the GMPP group.The clinical data(age,gender,duration of fever,duration of cough,extrapulmonary manifestations,chest imaging data and serological indicators)was compared between the two groups,and risk factors and receiver operating characteristic(ROC)curves were analyzed for RMPP.Results The age of(5.73±2.96)years in RMPP group was older than that of(4.56±2.07)years in GMPP group;the duration of fever of(7.16±1.77)d in RMPP group was longer than that of(3.55±2.23)d in GMPP group;In RMPP group,the extrapulmonary manifestation accounted for 43.18%,C-reactive protein(CRP)was(37.37±10.21)mg/L,provocalcitonin(PCT)was(0.23±0.16)ng/ml,lactate dehydrogenase(LDH)was(444.84±138.67)U/L,and the imaging manifestations of lung hyperdensity and pleural effusion accounted for 54.55%,which were higher than those of 16.95%,(8.25±3.18)mg/L,(0.11±0.10)ng/ml,(283.34±67.58)U/L and 10.17%(P<0.05)in GMPP group(P<0.05).There was no statistically significant difference between the two groups in terms of gender,duration of cough and white blood cell count(P>0.05).The development of RMPP was taken as a binary dependent variable(occurrence =1,non-occurrence =0).Logistic regression analysis showed that old age,long duration of fever and high LDH were all risk factors for RMPP(P<0.05).The ROC curve analysis of age,fever duration,and LDH for the diagnosis of RMPP showed that the area under the ROC curve(AUC)for LDH was the largest at 0.948,with a critical value of 312 U/L(sensitivity of 0.977,specificity of 0.805);followed by fever duration,with an AUC of 0.900,with a critical value of 5.50 d(sensitivity of 0.932 and specificity of 0.780);then age,with an AUC of 0.617,with a critical value of 4.50 years(sensitivity of 0.682 and specificity of 0.576).Conclusion RMPP is often manifested as a long duration of fever,combined with organ damage,high inflammatory indicators,and severe lung lesions.Older age of onset,long duration of fever,and high LDH level can be used as indicators for predicting the development of RMPP.
NETL
NSTL
万方数据
维普
