Analysis Of Risk Factors Associated With Severe Mycoplasma Pneumonia In Children

Objective:To investigate the risk factors of severe mycoplasma pneumonia(SMPP)in children,and to provide clinical evidence for the early diagnosis and judgement of the changes of condition with SMPP.Methods:Randomly selected 100 patients with SMPP(severe group)and 100 patients with MPP(mild group)from January 2016 to December 2017 in the comprehensive pediatric department of Qingdao University Affiliated Hospital,selected 100 normal children with physical examination(control group)during the same period,all children aged from 6 months to 13 years old.To analyse the relevant clinical datas retrospectively(including general conditions,past history,clinical manifestations,etiology,imaging performance,platelet parameters,blood clotting routine,serum protein),P<0.05 was considered statistically significant.Results:(1)General conditions:There was no statistically significant difference in gender,season,and region between the three groups;about the age distribution,the school-age children were common in severe group,and the preschool children were common in mild group(x~2=7.92,P<0.05);(2)Past history:atopic dermatitis,allergic rhinitis and recurrent respiratory infections were common in severe group than mild group(x~2=6.82,5.18,5.21,P<0.05),and there was no significant difference in bronchial asthma history and allergic family history;(3)Clinical manifestations:In the severe group,the heat peak was higher and the heat duration was longer than the mild group(x~2=9.67,34.66,P<0.05),and there was no significant difference in the nature and degree of cough between the two groups;(4)Etiology:The mixed infections in both groups were not statistically significant;after we classify the mixed infection,we found that bacterial were common in the severe group and virus were common in the mild group(x~2=8.11,P<0.05);(5)Imaging performance:compared with the mild group,large area lung consolidation was common in severe group,the right lung was affected obviously,and the incidence of complications were higher(x~2=171.34,6.75,73.31,P<0.05);(6)Laboratory examination:In the acute phase,compared with the mild group and the control group,the PT,APTT and Di in the severe group were significantly increased(F=42.15,14.48,90.97,P<0.05),and the PLT,PCT,ALB and PAB were significantly decreased(F=47.86,29.25,38.52,37.95,P<0.05);into the recovery period,PT,APTT and Di decreased significantly(t=2.07,2.64,4.58,P<0.05),PLT,PCT,ALB and PAB increased significantly(t=-13.31,-9.46,-8.87,-7.82,P<0.05);define the above indicators as an independent risk factor,the severity of the disease as a classification standard to draw ROC curve and calculate the corresponding critical value:PT 10.95sec,APTT 28.80 sec,Di 615.00 ng/ml,PLT 267.50×10~9/L,PCT 0.29%,ALB37.40g/L,PAB 163.35mg/L.Conclusions:(1)SMPP is common in school-age children,the incidence of SMPP is not related to gender,season and region;(2)For children with MPP,those who have the past history of atopic dermatitis/allergic rhinitis/recurrent respiratory infection,higher heat peaks,longer heat strokes,mixed bacterial infections,large lung consolidation particularly right lung was affected or combined pleural effusion/atelectasis,Di>615.00ng/ml,PT>10.95sec,PAB<163.35mg/L,ALB<37.40g/L,PLT<267.50×10~9/L,PCT<0.29%or APTT>28.80sec could be used as the risk factors for the early identification of SMPP;(3)For children with SMPP,when the symptoms or imaging improved,PT,APTT or Di decreased,PLT,PCT,ALB or PAB increased,suggesting that the condition enters the recovery period.