| Object:To explored the clinical,laboratory and radiologic characteristics of children with MPP,who have different ages in Yancheng,aiming to improve its early diagnosis and treatment.Methods:This study was conducted on 262 cases who were admitted in Pneumology Department of maternal and child health hospital in 2016.All these MPP cases met the diagnosis criteria developed by The Chinese academy of pediatrics.After admission,radiography was conducted,the next morning examination was done for MP-IgM,IgG,blood routine,CRP,PCT,liver function,myocardial enzymes etc.These 262 patients were divided into four groups(less than 1 yr,1-3 yrs,3-5yrs and older than 5 yrs)according to age.Based on examination results of the four groups,we investigated the relationships between MPP and gender,age,season,clinical features,laboratory inspection,X-ray images and extrapulmonary complications.SPSS 20.0 was used for analysis.Categorical data were analyzed using the chi-squared(?2)test or Fisher's exact test.Metrological data was analyzed for normality W test and variance homogeneity test.Normally distributed continuous variables were compared using the Student T test.Results:1.Among the 262 cases children from 3 years to 5 years were most likely to suffer MPP,but children younger than 1 years old had least chance.The incidence rates of children less than 1 year,1-3 years,2 years,3-5 years,older than 5 years,were 1.9%.25.9%?47.3%?24.8%respectively.Among the 262 cases of MPP,148 were males(56%),114 were females(44%).The male to female ratio was 1.3:l,i.e.,the males had more chances of getting MPP than females.2.Monthly distribution of the 262 cases of MPP children peaked in October,the number of MPP children in each month from January to December were:19,14,21,22,18,17,19,25,28,29,22,28.Most of the MPP children occurred in autumn and winter.111 cases(43%)occurred in spring and summer,151 cases(57%)occurred in autumn and winter.3.Of the 262 MPP children,170 had fever.There were no significant differences in fever between each group(P = 0.408).The fever percentage of MPP children<1 year,1-3 years,3-5 years and>5 years was 60%,60%,69%,80%,respectively.Of the 262 MPP children,170 had cough.There were no significant differences in cough between each group(P = 0.856).The cough percentage of MPP children<1 year,1-3 years,3-5 years and>5 years was 100%,97%,95%,92%,respectively.The proportion of wheezing in children<1 year was significantly higher than that of other age groups(1-3 years,3-5 years and>5 years)(p=0.003).The percentage of wheezing in each group was 60%,22%,21%,and 19%,respectively.The proportion of pulmonary rale in children<1 year was significantly higher than that of other age groups(1-3 years,3-5 years and>5 years)(p=0.003).The percentage of pulmonary rale in each group was 100%,89%,67%,and 22%,respectively.4.Patchy shadow was most commonly seen in MPP children<1 year,followed by children aged 1-3 years,3-5 years and>5 years,the difference was statistically significant(P = 0.001).The proportion of patchy shadow was 100%,54%,49%and 29%,respectively.Large infiltration was most commonly seen in MPP children>5 years.The difference was statistically significant(P= 0.038).The proportion of large infiltration was 0%,25%,21%and 32%.5.The proportion of atelectasis was significantly higher in children>5 years than those of other age groups(P = 0.000).The percentage of atelectasis was 0%,0%,2%and 9%,respectively.The incidence of bronchial occlusion in children<1 year was significantly lower than that in other groups(P = 0.000).The percentage of bronchial occlusion was 0%,13%,12%and 7%,respectively.There was no significant difference in the incidence of pleural effusion and pleurisy between each age group(all P>0.05).Extrapulmonary complication including the proportion of skin lesion and gastrointestinal tract lesion in>5 years group were significantly higher than other age groups(P<0.05).Extrapulmonary complication including the proportion of cardiovascular lesion in children<1 year was significantly lower than that in other groups(P = 0.002).There was no significant difference in the incidence of nervous system lesion between each age group(P>0.05)6.Laboratory tests showed that there was no significant difference in white blood cells,percentage of neutrophils,elevated CRP and percentage of PCT between each age group(P>0.05).The incidence of CK-MB elevation in children younger than 1 years old was significantly higher than that in other age groups(P = 0.002).The proportion of CK-MB elevation of children<1 year,1-3 years,3-5 years and>5 years was 40%,7%,3%and 3%,respectively.There was no significant difference in AST and AST between each age group(P>0.05).7.The differences of lobar pneumonia and bronchial pneumonia in children with MPP:? the age of children with lobar pneumonia was significantly higher than that of bronchial pneumonia(P = 0.003).The mean age of lobar pneumonia was 4.53 ± 2.5 years,while mean age of bronchial pneumonia was 3.49 ± 2.0 years.?The length of hospital stay of lobar pneumonia was significantly longer than that of bronchial pneumonia(P = 0.000).The hospitalization stay of bronchial pneumonia was 8.0 ± 2.4 days,while the hospitalization stay of lobar pneumonia was 10.1 ± 3.4 days.?The proportion of fever in lobar pneumonia was significantly higher than that in bronchial pneumonia(P = 0.003).The percentage of fever in lobar pneumonia and bronchial pneumonia was 84%and 63%,respectively.?There were no significant differences in cough between bronchial pneumonia and lobar pneumonia(P=1).? The proportion of wheezing in bronchial pneumonia lobar pneumonia was significantly higher than that in lobar pneumonia(P =0.003).The percentage of wheezing in bronchial pneumonia and lobar pneumonia was 44%and 18%,respectively.?The proportion of pulmonary rale in bronchial pneumonia lobar pneumonia was significantly higher than that in lobar pneumonia(P = 0.000).The percentage of pulmonary rale in bronchial pneumonia and lobar pneumonia was 65%and 21%,respectively.? The proportion of skin lesion were significantly higher in lobar pneumonia than those in bronchial pneumonia(P=0.029).The percentage of skin lesion were in bronchial pneumonia and lobar pneumonia was 2%and 9%.?There were no significant differences in extrapulmonary complication including the proportion of gastrointestinal trasct lesion,nervous lesion,and cardiovascular lesion,between bronchial pneumonia and lobar pneumonia(all P>0.05).?The percentage of white blood cell count in bronchial pneumonia was significantly higher than that in lobar pneumonia(P = 0.024).The percentage of white blood cell count in bronchial pneumonia and lobar pneumonia was 88%and 75%,respectively.?CRP,ALT and PCT elevation were significantly higher in lobar pneumonia than those in bronchial pneumonia(all P<0.05).11 There were no significant differences in elevation in CKMB,the proportion of neutrophils and AST between bronchial pneumonia and lobar pneumonia(all P>0.05).Conclusion:1.Of 262 children with MPP,more occurs in 3-5yrs.2.Fever and cough are commonly seen in MPP children.MPP children with different age groups have different clinical characteristics.MPP children<1 age group are prone to wheezing.MPP children<1 age usually presented with bronchial pneumonia,less complications.Wheezing is not commonly seen in MPP children>5 years.MPP children>5 years usually presented with lobar pneumonia,more complications. |
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