Clinical Features And Early Identification Of Children With Refractory Mycoplasma Pneumoniae Pneumonia

Objective To investigate the clinical features of children with refractory mycoplasma pneumonia pneumonia(RMPP)and provide evidence for early detection and early intervention.Methods From June 2016 to June 2017,136 children with mycoplasma pneumonia who had been diagnosed with lobar pneumonia by the Department of Pediatrics of the Fourth Affiliated Hospital of China Medical University were divided into two groups: 104 cases in the MPP group and 32 cases in the RMPP group,the clinical manifestations,laboratory examinations,and imaging findings of the two groups were compared,and multivariate logistic regression analysis was performed.Results1.The average length of hospital stay in the RMPP group was 14.38±3.43 d,which was significantly higher than that of the normal MPP group 11.62±2.36d(P<0.05);The average duration of fever in the RMPP group was 12.49±3.34 d.,The average MPP group was 7.10±2.57 d.There was a statistically significant difference between the two groups(P<0.05).The complications of extrapulmonary complications were more likely to occur in the RMPP group than in the normal group(P<0.05).2.Compared with ordinary MPP group,RMPP group,The percentages of blood neutrophils,serum high-sensitivity C-reactive protein,lactate dehydrogenase,plasma D-dimer and ESR were all significantly higher,while serum iron was significantly lower than that of the normal MPP group.The difference was statistically significant(P<0.05).3.In the RMPP group,62.5% of children with two or more lobes were affected by consolidation,which was significantly higher than that of the normal MPP group(23.1%)(P<0.05).4.Multivariate logistic regression analysis showed that the fever time was >10 days,serum high-sensitivity C-reactive protein was >30 mg/L,plasma D-dimer was >550 ng/m L,serum iron was <6.0 μmol/L,and consolidation was affected with two or more lobes were independent risk factors for RMPP.Conclusion The imaging findings of MPP patients with lobar pneumonia showed that RMPP had a longer duration of fever than normal MPP,serum high-sensitivity C-reactive protein and plasma D-dimer were significantly higher,while serum iron was significantly lower.Imaging findings of MPP patients with lobar pneumonia,when fever time> 10 days,serum high-sensitivity C-reactive protein> 30 mg/L,plasma D-dimer>550 ng/m L,serum iron <6.0 μmol/L and two or more lobes are involved in the actual metamorphosis,it is suggested that RMPP is possible and and it is considered as an early indicator of RMPP.