CAJ | 학술논문

目的探讨难治性肺炎支原体肺炎的临床危险因素及其在早期诊断中的临床意义。方法回顾性分析2012年1月至2014年1月收治的142例肺炎支原体肺炎患儿的临床资料，比较30例难治性肺炎支原体肺炎及112例普通型肺炎支原体肺炎患儿临床资料的差异，并进行多因素Logistic回归分析。结果与普通型支原体肺炎相比，难治性支原体肺炎患儿的热程更长，肺外并发症、单侧肺部受累、肺部大片实变影的比例更高，中性粒细胞比例和C反应蛋白水平也更高(P均<0.05)。Logistic回归分析显示，影像学表现为肺部大片实变影(OR=6.57，95%CI：2.10~20.56)、有肺外并发症(OR=11.66，95%CI：2.42~56.08)、CRP升高(OR=14.87，95%CI：2.67~82.79)为儿童难治性支原体肺炎的临床危险因素(P均<0.01)。结论肺部影像学表现为大片实变影、C反应蛋白升高明显对早期难治性支原体肺炎的诊断具有一定的临床指导价值。
목적탐토난치성폐염지원체폐염적림상위험인소급기재조기진단중적림상의의。방법회고성분석2012년1월지2014년1월수치적142례폐염지원체폐염환인적림상자료，비교30례난치성폐염지원체폐염급112례보통형폐염지원체폐염환인림상자료적차이，병진행다인소Logistic회귀분석。결과여보통형지원체폐염상비，난치성지원체폐염환인적열정경장，폐외병발증、단측폐부수루、폐부대편실변영적비례경고，중성립세포비례화C반응단백수평야경고(P균<0.05)。Logistic회귀분석현시，영상학표현위폐부대편실변영(OR=6.57，95%CI：2.10~20.56)、유폐외병발증(OR=11.66，95%CI：2.42~56.08)、CRP승고(OR=14.87，95%CI：2.67~82.79)위인동난치성지원체폐염적림상위험인소(P균<0.01)。결론폐부영상학표현위대편실변영、C반응단백승고명현대조기난치성지원체폐염적진단구유일정적림상지도개치。
Objective To identify the clinical risk factors of refractory Mycoplasma pneumoniae pneumonia (RMPP) and their values in early diagnosis. Methods The retrospective analysis of clinical data was conducted in 142 children with Myco-plasma pneumoniae pneumonia (MPP) admitted to Changhai Hospital of Second Military Medical University from Jan. 2012 to Jan. 2014. All children were divided into two groups, RMPP group (n=112) and MPP group (n=30). The comparison was made between two groups in clinical data. The factors were analyzed by the multifactor logistic regression. Results As compared to MPP, RMPP had longer fever duration, the higher ratios of large consolidation shadows, extrapulmonary complications and in-creased CRP level (P<0.05). The results of logistic regression indicated that the clinical risk factors included large consolidation shadows (OR=6.57, 95%CI:2.10-20.56), extrapulmonary complications (OR=11.66, 95%CI:2.42-56.08) and CRP (OR=14.87, 95%CI:2.67-82.79) (P<0.01). Conclusions Large consolidation shadows, extrapulmonary complications and CRP are clinical risk factors of RMPP. CRP elevation and lung imaging changes are valuable in early diagnosis of RMPP.