重症肺炎支原体肺炎患儿临床特征与实验室指标及预后的关系

Clinical characteristics and correlation between laboratory indicators and prognosis of children with severe Mycoplasma pneumoniae pneumonia

  • 摘要:
    目的 分析重症肺炎支原体肺炎(SMPP)患儿临床特征, 实验室指标与预后的关联。
    方法 选取2021年11月-2024年5月安徽省儿童医院收治的85例SMPP患儿为研究对象, 根据入院时临床分型分为高危组59例和低危组26例, 比较两组临床表现、实验室指标及治疗28 d的结局。
    结果 高危组患儿入院前发热时间和咳嗽时间分别为(7.17±1.09)d和(6.79±1.25)d长于低危组(P<0.05);两组患儿肺部听诊(喘鸣音、湿啰音)和肺外并发症差异无统计学意义。高危组患儿C-反应蛋白(CRP)、淀粉样蛋白A(SAA)、血小板(PLT)、纤维蛋白原(FIB)、D-二聚体(DD)、N-末端脑钠素原(NT-proBNP)分别为(11.62±1.45)mg/L、(226.88±36.83)mg/L、(318.57±39.82)×109/L、(4.28±0.74)g/L、(0.81±0.12) μg/ml、(2 295.48±413.75)pg/ml, 均高于低危组(P<0.05)。两组患儿治疗后28 d内, 高危组患儿出现1例死亡。
    结论 与低危组SMPP患儿相比, 高危组患儿预后死亡风险较高, 提示患儿血CRP、SAA、PLT、FIB、DD、NT-proBNP与SMPP患儿预后具有相关性。

     

    Abstract:
    OBJECTIVE To analyze the clinical characteristics and the correlation between laboratory indicators and prognosis of severe Mycoplasma pneumoniae pneumonia (SMPP) in children.
    METHODS A total of 85 children with SMPP admitted to Anhui Provincial Children′s Hospital from Nov. 2021 to May 2024 were selected as the study subjects. Based on clinical typing at admission, they were divided into a high-risk group (n=59) and a low-risk group (n=26). The clinical manifestations, laboratory indicators and outcomes at 28 days of treatment were compared between the two groups.
    RESULTS The duration of fever and cough before admission in the high-risk group was (7.17±1.09) days and (6.79±1.25) days, respectively, which was longer than that in the low-risk group (P < 0.05). There were no statistically significant differences in pulmonary auscultation (wheezing rales, moist rales) and extrapulmonary complications between the two groups. The levels of C-reactive protein (CRP), serum amyloid A (SAA), platelets (PLT), fibrinogen (FIB), D-dimer (DD) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in the high-risk group were (11.62±1.45) mg/L, (226.88±36.83) mg/L, (318.57±39.82) ×109/L, (4.28±0.74) g/L, (0.81±0.12) μg/ml and (2 295.48±413.75) pg/ml, respectively, all of which were higher than those in the low-risk group (P < 0.05). Within 28 days after treatment of children in both groups, one patient in the high-risk group died.
    CONCLUSIONS Compared with children with SMPP in the low-risk group, those in the high-risk group have a higher risk of prognostic mortality, suggesting a correlation between the children′s blood CRP, SAA, PLT, FIB, DD and NT-proBNP levels and the prognosis of children with SMPP.

     

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