儿童肺炎支原体肺炎的肺外表现分析

发布时间：2018-04-15 23:28

本文选题：肺炎支原体肺炎 + 肺外表现　；参考：《吉林大学》2017年硕士论文

【摘要】：目的分析儿童肺炎支原体肺炎患者肺外表现的发生情况,并探究其危险因素,以期为早期识别及防治肺外表现的发生提供更多依据。方法研究对象为2015年12月至2016年11月期间于吉林大学第二医院儿科住院的肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)患儿208例,对这些患儿的肺外表现情况进行统计,分别计算每个系统的肺外表现的发生率。根据是否伴发肺外表现将患儿分为2组,分析研究性别、年龄、临床表现、早期应用大环内酯类抗生素、CRP、热程等对于MPP患儿发生肺外表现的影响。结果MPP伴发的肺外表现几乎涉及机体的所有系统,有肺外表现者共85例,无肺外表现者共123例,总发生率为40.86%。消化系统表现38例(18.27%),心血管系统表现30例(14.42%);泌尿生殖系统表现16例(7.69%),皮肤黏膜系统表现15例(7.21%),神经系统表现6例(2.88%),血液系统表现3例(1.44%),关节、肌肉表现1例(0.48%),其他表现3例(1.44%)。研究对象中85例为伴发肺外表现患儿,123例为不伴发肺外表现患儿。两组患儿之间的性别、年龄、热程差异均无统计学意义(p0.05)。与对照组相比,伴发肺外表现组更多伴有肺部大片影,从发病到应用大环内酯类药物的时间(天数)更长,CRP水平更高(p均0.05)。多因素Logistic回归分析结果提示从发病到应用大环内酯类药物的时间长(OR=1.726,95%CI:1.412-2.110)、CRP高(OR=1.086,95%CI:1.051-1.123)及影像学检查提示肺部大片影(OR=3.311,95%CI:1.468-7.470)为MPP患儿发生肺外表现的独立危险因素(p均0.05)。结论1.儿童MPP伴发的肺外表现几乎涉及机体的所有系统。2.MPP患儿中CRP较高者、影像学检查提示肺部大片影者更容易发生肺外表现。3.从发病到应用大环内酯类药物的时间长是MPP患儿发生肺外表现的危险因素,提示早期应用大环内酯类药物可能减少肺外表现的发生。
[Abstract]:Objective to analyze the occurrence of extrapulmonary manifestations in children with mycoplasma pneumoniae pneumonia and explore its risk factors in order to provide more evidence for early identification and prevention of extrapulmonary manifestations.Methods from December 2015 to November 2016, 208 children with Mycoplasma pneumoniae pneumonia (Mycoplasma pneumoniae) in pediatrics hospital of Jilin University were studied.The incidence of extrapulmonary manifestations in each system was calculated separately.The children were divided into two groups according to their extrapulmonary manifestations. Sex, age, clinical manifestations, early use of macrolide antibiotics CRP and fever were analyzed to study the influence of sex, age, clinical manifestations and fever on extrapulmonary manifestations in children with MPP.Results the extrapulmonary manifestations of MPP involved almost all the systems of the body. There were 85 cases with extrapulmonary manifestations and 123 cases with no extrapulmonary manifestations. The total incidence rate was 40.86%.Digestive system in 38 cases, cardiovascular system in 30 cases, urogenital system in 16 cases, urogenital system in 15 cases, skin and mucosal system in 15 cases, nerve system in 6 cases, blood system in 3 cases, joints and muscles in 1 case, and other manifestations in 1 case.Of 85 children with extrapulmonary manifestations, 123 were children without extrapulmonary manifestations.There was no significant difference in sex, age and fever course between the two groups (P 0.05).Compared with the control group, the patients with extrapulmonary manifestations were more accompanied with large shadow of lung, and the time (days) from the onset to the application of macrolides was longer and the level of CRP was higher than that of the control group (P < 0.05).The results of multivariate Logistic regression analysis showed that the time from onset to application of macrolides was 1.726 ~ 95% CI: 1.412-2.110%, and OR1.08695% CI 1.051-1.123) and imaging examination showed that pulmonary bulge was 3.31195CIW 1.468-7.470) as an independent risk factor for extrapulmonary manifestations in MPP children.Conclusion 1.The extrapulmonary manifestations associated with MPP in children involve almost all of the system of the body. 2. In children with MPP, CRP is higher, and imaging examination shows that pulmonary mass shadow is more likely to develop extrapulmonary manifestations.The long time from onset to use of macrolides is the risk factor of extrapulmonary manifestations in children with MPP, suggesting that the early use of macrolides may reduce the incidence of extrapulmonary manifestations.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.6

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