CAJ | 학술논문

目的：探讨肺炎支原体肺炎( mycoplasma pneumoniae pneumonia, MPP)出现肺外表现的危险因素,以期通过早期干预,减少或避免其发生。方法回顾分析2011年1月—2014年10月我院儿科收治的确诊为MPP 558例的临床资料,根据有无出现肺外表现分为肺外表现组(235例)和无肺外表现组(323例)。收集两组性别、年龄、发热、高热、肺部啰音、血白细胞计数、C反应蛋白、胸片X线病变类型、入院前病程、大环内酯类抗生素使用初始时间等临床资料,并进行单因素分析及多因素Logistic回归分析。结果558例MPP肺外表现发生率为42.11%,涉及全身多个系统,其中以泌尿系统和心血管系统最为多见,分别占15.41%和7.35%。单因素分析结果提示叶或节段性肺炎、入院前病程、血白细胞计数、C反应蛋白及大环内酯类抗生素使用初始时间5个因素为MPP出现肺外表现的危险因素。多因素Logistic回归分析显示,上述5个因素仍为促使肺外表现发生的危险因素,其 OR 值分别为3.660、1.278、1．143、0.977、0.652。结论 MPP出现肺外表现临床并不罕见,可涉及全身多个系统。叶或节段性肺炎及入院前病程是促使MPP肺外表现发生的2个较为重要危险因素。
목적：탐토폐염지원체폐염( mycoplasma pneumoniae pneumonia, MPP)출현폐외표현적위험인소,이기통과조기간예,감소혹피면기발생。방법회고분석2011년1월—2014년10월아원인과수치적학진위MPP 558례적림상자료,근거유무출현폐외표현분위폐외표현조(235례)화무폐외표현조(323례)。수집량조성별、년령、발열、고열、폐부라음、혈백세포계수、C반응단백、흉편X선병변류형、입원전병정、대배내지류항생소사용초시시간등림상자료,병진행단인소분석급다인소Logistic회귀분석。결과558례MPP폐외표현발생솔위42.11%,섭급전신다개계통,기중이비뇨계통화심혈관계통최위다견,분별점15.41%화7.35%。단인소분석결과제시협혹절단성폐염、입원전병정、혈백세포계수、C반응단백급대배내지류항생소사용초시시간5개인소위MPP출현폐외표현적위험인소。다인소Logistic회귀분석현시,상술5개인소잉위촉사폐외표현발생적위험인소,기 OR 치분별위3.660、1.278、1．143、0.977、0.652。결론 MPP출현폐외표현림상병불한견,가섭급전신다개계통。협혹절단성폐염급입원전병정시촉사MPP폐외표현발생적2개교위중요위험인소。
Objective To identify the risk factors of extrapulmonary manifestations in children with mycoplasma pneumoniae pneumonia ( MPP) , in order to reduce or prevent its occurrence through early intervention. Methods The clini-cal data of 558 hospitalized children with MPP from January 2011 to October 2014 were retrospectively reviewed. Based on the findings of extrapulmonary manifestations, the subjects were divided into 2 groups: the extrapulmonary manifestation group (235 cases) and non-extrapulmonary manifestation group (323 cases). The clinical data included gender, age, fever, hyper-pyrexia, rales, white blood cell count(WBC), C reaction protein(CRP), the manifestation of pneumonia on X-ray, the course of disease before admission, the initial time of macrolide antibiotics usage and so on. Single factor analysis and Logistic regression analysis were made in 2 groups. Results In up to 42. 11% of cases, a wide variety of extrapulmonary manifesta-tions occurred, which involved multiple body systems. The most 2 involved systems were urinary system and circulatory sys-tem, accounting for 15. 41% and 7. 35% respectively. Strong univariate associations suggested that some factors increase the risks of the occurrence of extrapulmonary manifestations of MPP: lobar/segmental MPP, the course of disease before admis-sion, WBC, CRP, the initial time of macrolide antibiotics usage. With multiple Logistic regression, independent risk factors of the occurrence of extrapulmonary manifestations of MPP were lobar or segmental MPP (OR=3. 660), the course of disease before admission (OR=1. 278), WBC (OR=1. 143), CRP (OR=0. 977) and the initial time of macrolide antibiotics us-age (OR=0. 652). Conclusion The extrapulmonary manifestations of MPP are not rare involving multiple body systems. Lobar or segmental MPP and the course of disease before admission are the two most important risk factors of inducing the oc-currence of extrapulmonary manifestations of MPP.