The Analysis Of Cases Of Mycoplasma Pneumonia In Children From A Hospital In Qiqihar City From 2015 To 2017

Objective: To analyze the clinical characteristics of children with mycoplasma pneumonia in a hospital in Qiqihar city from 2015 to 2017 and study the factors affect the prognosis of mycoplasma pneumonia children.Methods: A total of 442 children diagnosed with mycoplasma pneumonia admitted into a hospital in Qiqihar city from 2015 to 2017 were selected into our hospital.All children were divided into 3 groups: <1 year,1 to 3 years and 3 to 14 years groups.The fever,the duration of fever,respiratory symptoms(cough,wet rales,wheezing,and dyspnea,etc.),extrapulmonary symptoms(cardiovascular system,digestive system,urinary system,and others),chest radiographs(patch shadow,leaf/segmental consolidation,pulmonary interstitial lesions,bilateral lesions,pleural effusion and others)and hematological parameters [ white blood cell(WBC),hemoglobin(Hb),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)].All children accepted sequential treatment of azithromycin or azithromycin.The efficacies of all children were recorded.The patient's prognosis was used as a dependent variable,the time of illness,the age of the child(<1 year,1-3 years,and 3-14 years),gender(male,female),weight,height,fever and duration of fever,respiration symptoms,extrapulmonary symptoms,chest radiographs and hematological parameters were used as independent variables for Logistic multivariate regression analysis.Results: Mycoplasma pneumonia happened in 4 seasons,89 cases(20.14%)occured in the spring from January to March,65 cases(14.71%)in the summer from April to June,86 cases(19.46%)in the fall from July to September and 202 cases(45.70%)occurred in winter from October to December.The peak of the mycoplasma pneumonia was winter from October to December.442 children had different degrees of fever.The duration of fever in 85 children <1 year old was 1 ~15 days,with an average 4.5 ± 1.6 days.The duration of fever in 210 children aged 1 to 3 years was 1 ~ 26 days,with an average 6.2 ± 2.4 days.The duration of fever in 90 children aged 3 to 14 years was 1 ~35 days,with an average 7.6 ± 2.7 days.Compared with the <1 year old group,the proportion of moderate-to-high fever and the duration of fever was higher or longer in the 1 to 3 year-old group and the 3 to 14 year old group(P<0.05).Compared with the 1 to 3 years group,the proportion of high fever and the duration of fever in the 3 to 14 years group was higher or longer(P<0.05).The duration of fever at different age groups had the trend of extending,which in 2017 was the longest(P>0.05).3 groups had different degrees of cough,dry and wet rales,wheezing and dyspnea.There had no statistically significant differences in cough among 3 groups(P>0.05).The dry and wet rales in the <1 year group and 1 to 3 year group were comparable,with no statistically significant difference(P>0.05).Compared with the <1 year group,there were less wheezing and dyspnea in the 1 to 3 years group and 3 to 14 year group(P<0.05).The cases of wheezing and dyspnea were similar in the 1 to 3 years group and 3 to 14 years group(P>0.05).With time went by,children in 3 groups had more cases of cough,dry and wet rales,wheezing,and dyspnea or had a tendency to increase.There were different degrees of extrapulmonary damage in children of 3 groups.With the increase of age,the cases of extrapulmonary lesions had increased,but the difference was not statistically significant(P>0.05).There were different degrees abnormal chest radiographs in 3 groups.With increasing age,the cases of shadows in chest radiographs decreased(P>0.05),the cases of the leaf/segmental consolidation,pulmonary interstitial lesions,bilateral lesions and pleural effusion and the others had increased(P>0.05).As time went by,the cases of chest patch patches in 3 groups had a decreasing trend,leaf/segmental consolidation,pulmonary interstitial lesions,bilateral lesions,pleural effusion and the others had an increasing trends.There were different levels of WBC,CRP and ESR increase and Hb decrease in 3 groups.With the increased age,ESR had increased(P<0.05).The change of WBC,CRP and Hb were similar in 3 groups(P>0.05).As time went by,the increase of WBC,CRP and ESR and the decrease of Hb were similar in 3 groups,with no statistically significant difference(P>0.05).With the increased age,the cases of cured decreased,and the cases of invalid increased(P<0.05).As time went by,the cases been cured in 3 groups has decreased and the invalid cases had increased(P<0.05).The factors affected the prognosis of mycoplasma pneumonia children included the age,respiratory symptoms,chest X-ray abnormalities,extrapulmonary damage,underlying disease in the lungs,and elevated ESR(P<0.05).Height,weight,Hb,hospital stay,gender,WBC and CRP did not affect the prognosis(P>0.05).Conclusion: Mycoplasma pneumoniae mostly occurs in winter.The clinical manifestations of mycoplasma pneumonia were the following: children in <1 year group have rare high fever and short heating time,mainly suffer from wheezing,dyspnea,pulmonary rales and patches,accompanied by extrapulmonary damage such as cardiovascular system and digestive system,clinical symptoms are light,recovery is faster.Children of 1 to 3 years and 3 to 14 years show persistent high fever,cough,pulmonary rales and small patches,which may accompany injury in the lungs such as the cardiovascular system and the digestive system.The clinical manifestations of mycoplasma pneumonia are various,and there are many factors affecting mycoplasma pneumonia's prognosis.Age,respiratory symptoms,abnormal chest X-ray,extrapulmonary damage,underlying lung diseases and elevated ESR affect the prognosis of children mycoplasma pneumonia.