Clinical Risk Factor Analysis Of Childhood Refractory Mycoplasma Pneumoniae Pneumonia

Objective:To identify the clinical risk factors of refractory Mycoplasma pneumoniae pneumonia.Methods:The retrospective analysis of clinical data was conducted in 200 children with Mycoplasma pneumoniae pneumonia(MPP) admitted to The First Hospital of Jilin University from Jan.2014 to Jan.2016.These cases are defined as refractory Mycoplasma pneumoniae pneumonia(MPP)showing clinical and radiological deterioration after macrolide antibiotic therapy for 7 days or more.All children were divided into two groups,RMPP group(n=122) and MPP(n=78).The comparison was made between two groups in clinical.The factors were analyzed by the multifactor logistic regression.The critical values of each independent factors related with RMPP had been detected.Results:1.RMPP and MPP two groups there was no statistically significant difference in gender.As compared to MPP,RMPP was statistically significant difference in age(P<0.05), median age in RMPP group was older than MPP group.As compared to MPP,there was statistically significant difference in neutrophilic granulocyte percentage,CRP and LDH(P < 0.05), mean of neutrophilic granulocyte percentage,median CRP and median LDH in RMPP group was higher than MPP group.Ascompared to MPP,there was statistically significant difference in pleural effusion(P<0.05),the incidence of pleural effusion was 39.7% in RMPP group,and MPP group was 4.1%.The incidence of pleural effusion in RMPP group was higher than MPP group(X2=40.958,P=0.000).2.The results of logistic regression indicated that the clinical risk factors include large consolidation shadows(OR=31.231, 95%CI :7.971~122.373),CRP(OR=1.047,95%CI:1.021~1.074)、LDH(OR=1.006,95%CI:1.001~1.012).3.Caculated by the area under the ROC curves,the CRP and LDH were the prediction indicators of RMPP.The cut off value was22.05mg/L、314.5IU/L。Conclusion:(1) Median age in RMPP group was older than MPP group.Mean of neutrophilic granulocyte percentage,median CRP and median LDH in RMPP group was higher than MPP group.The incidence of pleural effusion and large consolidation shadows in RMPP group was higher than MPP group.(2) the clinical risk factors of RMPP included large consolidation shadows,CRP and LDH.RMPP is suggested CRP≥22.05mg/L,LDH≥314.5IU/L and large consolidation shadows.