114例肺炎支原体肺炎临床特征及混合感染影响因素

Clinical manifestation and factors affecting mixed infection in 114 patients with Mycoplasma pneumoniae pneumonia

  • 摘要:
    目的 了解肺炎支原体(MP)感染患者临床特征, 并探讨混合感染相关影响因素, 为临床MP感染诊治提供理论参考。
    方法 收集2023年12月-2024年4月在解放军第305医院诊断为MP感染患者的临床资料, 分析MP感染患者临床特征, 比较MP混合其他病原体感染对病情严重程度的影响, 采用logistic回归模型分析MP混合其他病原体感染的影响因素。
    结果 共收集MP感染患者114例, 男女均为57例(50.00%), 60例(52.63%)为成人, 单纯MP感染者73例(64.04%), 混合感染者41例(35.96%)。MP感染患者的临床表现主要为发热和咳嗽, 其中发热多为低热或中热, 咳嗽多为湿性咳嗽。生化指标多处于正常值范围, 但白细胞介素-6(IL-6)偏高, 行胸部X线检查异常者占84.21%。与单纯MP感染病例相比, 混合感染病例出现发热、头晕乏力、头痛及肌肉酸痛等症状的比例更高(P<0.05)。混合感染组CRP高于单纯MP感染组(P=0.001), 而白细胞水平、淋巴细胞计数低于单纯MP感染组(P<0.05)。多因素logistic回归分析结果显示, 发热(OR=4.112, 95%CI:1.046~16.161)以及≥46岁(OR=8.555, 95%CI:1.394~52.493)的年龄段是MP混合其他病原体感染的重要影响因素。
    结论 MP感染者临床特征不典型, 但IL-6多偏高;MP常混合病毒感染, 发热、≥46岁是MP混合感染的危险因素。

     

    Abstract:
    OBJECTIVE To understand the clinical characteristics of patients with Mycoplasma pneumoniae (MP) infection, and to explore the related factors of mixed infection, to provide theoretical support for the diagnosis and treatment of MP infection.
    METHODS The clinical data of patients diagnosed with MP infection in the 305th hospital of PLA from Dec. 2023 to Apr. 2024 were collected, and the clinical characteristics of patients infected with MP were analyzed. Additionally, the impacts of MP mixed infections with other pathogens on the severity of the disease were compared, while the relevant influencing factors of MP mixed with other pathogens were analyzed by the logistic regression model.
    RESULTS A total of 114 patients with MP infection were collected, both genders had 57 cases (50.00%, respectively), 60 (52.63%) were adults, 73 (64.04%) had simple MP infection and 41 (35.96%) had mixed infection. The clinical manifestations of MP infection primarily included fever and cough, with most fevers being low to medium intensity. Additionally, the biochemical indexes were predominantly within normal ranges, however, the interleukin 6 (IL-6) level was relatively high. The abnormalities of chest X-ray examination accounted for 84.21% of the cases. In mixed infection cases, fever, dizziness, fatigue, headache and muscle pain were more prevalent than single MP infection cases (P < 0.05), and CRP level elevated in the mixed infection group (P=0.001), whereas white blood cell level and lymphocyte count decreased compared to the single MP infection group (P < 0.05). Multivariate logistic regression analysis showed that fever (OR=4.112, 95%CI: 1.046-16.161) and above 46 years old (OR=8.555, 95%CI: 1.394-52.493) were the relevant influencing factors for MP mixed with other pathogens infection.
    CONCLUSION Clinical features of MP-infected patients are atypical, but IL-6 levels are relatively high. MP is often mixed with viral infections, and fever and above 46 years old are the risk factors for mixed MP infection.

     

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