| Objective: To observe the clinical characteristics and the incidence of immune dysfunction in children with MPP at different ages,and to explore the characteristics of immune dysfunction in elderly children with MPP in different conditions,and provide theoretical basis for clinical diagnosis and treatment.Methods: A retrospective analysis was used to select 270 MPP patients who met the inclusion criteria from July 2014 to December 2018 in Dalin Children's Hospital.According to age,the children were divided into infant group and elderly group.The clinical characteristics and immune dysfunction rate of the two groups were recorded and compared.The elderly group was further divided into severe MPP group and mild MPP group according to the severity of the disease.The characteristics of the changes of immune function were compared and analyzed statistically.Result:1.A total of 270 children with MPP met the inclusion criteria,with an average age of 4.64±3.03 years.There were 110 cases in infant group,including 46 cases in severe group(41.82%)and 64 cases in mild group(58.18%);160 cases in elderly group,81 cases in severe group(50.63%)and 79 cases in mild group(49.37%).2.99 cases of febrile MPP in infant group had febrile duration of 8.78 ±6.06 days,153 cases of febrile MPP in elder group had febrile duration of 10.51±6.24 days.Comparison between the two groups,P <0.05,the difference was significant,statistically significant.The incidence of wheezing,shortness of breath and dyspnea in infant group was 58.18%,35.45% and 16.36%,respectively.The incidence of wheezing,shortness of breath and dyspnea in elder group was 23.13%,15.00% and 8.13%,respectively.Comparison between the two groups,P <0.05,the difference was significant,statistically significant.Lobular pneumonia was the most common type of pulmonary lesions in infants,accounting for 46.15%,followed by interstitial changes,accounting for 23.08%;lobar pneumonia was the most common type of pulmonary lesions in older children,accounting for 60.00%.The incidence of interstitial change,lobular pneumonia and lobar pneumonia were 27.27%,54.55% and 36.36% in infant group and 12.50%,31.25% and 65.63% in elderly group respectively.Comparison between the two groups,P <0.05,the difference was significant,statistically significant.3.Among 270 MPP children who met the inclusion criteria of this study,183 had complications,accounting for 67.78%.Among 183 children with complications,extrapulmonary complications accounted for 48.09%.The most common pulmonary complications in infants and older children were pleural effusion,accounting for 74.19% and 71.08% respectively.The most common extrapulmonary complications in infant group and elderly group were skin system,accounting for 29.17% and 30.86% respectively.4.Among 270 children with MPP,immune dysfunction was the most common(76.56%).Among infants with MPP,the abnormal rates of immune function,humoral immune function,cellular immune function and mixed immune function were 95.59%,72.06%,66.18% and 55.88%,respectively,the abnormal rates of immune function,humoral immune function,cellular immune function and mixed immune function were 67.38%,49.65%,43.26% and 29.08% respectively.Comparison between the two groups,P <0.05,the difference was significant,statistically significant.5.The IgM of MPP children in the elderly severe group was(2.15±1.29)g/L,and that of MPP children in mild group was(1.77±0.70)g/L.Comparison between the two groups,P <0.05,the difference was significant,statistically significant.CD3,CD4 and CD4/CD8 of MPP patients in the elderly severe group were(59.87±10.14)%,30.92±8.37)%,CD4/CD8 1.34±0.56),respectively.In mild MPP group,CD3,CD4 and CD4/CD8 were(66.35±8.60)%,(36.32±6.83)% and CD4/CD8 1.50±0.39,respectively.Comparison between the two groups,P <0.05,the difference was significant,statistically significant.Conclusion:1.The clinical characteristics of MPP children in different age groups are different.Compared with older children,infants and young children have shorter fever duration and are prone to wheezing,shortness of breath and dyspnea.The main imaging manifestations of the lungs are patchy shadow and interstitial changes.2.Children with MPP are prone to complications.The most common pulmonary complications are pleural effusion.The most common extrapulmonary complications are skin system involvement.3.Infants and elderly children with severe illness in MPP are more likely to suffer from immune dysfunction.We should pay attention to these children and make timely clinical intervention. |
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