| Objective:To investigate the risk factors of mycoplasma pneumoniae in children with severe pneumonia,and to provide reference for clinical diagnosis and treatment.Methods:A total of 201 cases of children with mycoplasma pneumoniae pneumonia in our hospital from 2015 to 2017 were selected as the research objects,which were divided into severe group(50 cases)and mild group(151 cases)according to the disease conditions.Comparison between the two groups of children’s age,gender,cough days prior to admission,and fever days prior to admission,and total hot days,on the day of admission,extraction of peripheral white blood cells(WBC)count,neutrophil percentage(N %),lymphocyte percentage(L %),neutrophil counts,hypersensitive c-reactive protein(CRP)and blood sedimentation(ESR),calcitonin(PCT),immunoglobulin G(IgG),immunoglobulin M(IgM),immunoglobulin A(IgA),the C3,complement C4,cereal third transaminase(ALT),aspertate aminotransferase(AST),lactate dehydrogenase(LDH),chestMinistry of imaging and other indicators of the difference.After multiariable Logistic regression analysis,the prediction of severe pneumonia mycoplasma pneumonia in children associated risk factors,find the best cutting through the ROC curve,draw relevant area under the curve of the risk factors,to establish severe pneumonia mycoplasma pneumonia risk factor prediction model,finally through the partial regression coefficient as reference to set up clinical assessment to help determine severe pneumonia mycoplasma pneumonia(SMPP).Result:1.In general,there was no significant difference in gender between thetwo groups.2.The age of mild children is between 1 and 13 years old,the minimum age is 1 year and 3 months,the maximum age is 13 years and 6 months,and the preschool age is 92 cases(60.93%).The intensive group was between September and12 years old,the minimum age was September,the maximum age was 12 years and 5months,and the preschool age was the main,29 cases(58.0%),the two groups were different.The incidence rate at the age stage(P>0.05)was not statistically significant.The fever days before admission in the mild group were about 2.00(0.00-5.00),and the fever days before admission in the severe group were about 4.00(1.00-6.00).The comparison between the two groups(P <0.05)was statistically significant.All children had cough performance,but because the degree and nature of cough were difficult to quantify,subjective judgment of the examinee had a great influence and was not systematically studied.2.Laboratory results: by single factor analysis,ever days in the front yard,total fever days,,neutrophil count,N%,CRP,ESR,IgM,IgG,ALT,AST,LDH,C4 were statistically significant(P<0.05).There were no significant differences in WBC,L%,PCT,IgA,and C3.3.Imaging findings: The severe group was mainly oozing,and the lower right lung was mainly 27 cases(54.00%).The mild group was mainly 117 cases with spots and patch exudation(accounting for 77.48%).4.Complication:In the mild group,3 cases were intrapulmonary complications,mainly pleural effusion,19 cases were extrapulmonary complications,10 cases were myocardial involvement,8 cases were mild digestive system involvement,and 1 case was electrolyte disorder.There were 11 cases of intrapulmonary complications in the severe group,7 cases of pleural effusion,2 cases of atelectasis,2 cases of occlusive bronchus;43 cases of extrapulmonary complications,23 cases of myocardial involvement,10 cases of digestive system involvement,There were 3 cases of central nervous system involvement,3 electrolyte imbalances,2 urinary system involvement,and 2 multiple organ function systems.5.Multivariate logistic regression analysis showed that CRP,IgG,IgM and LDH were independent risk factors of smpp.Conclusion: 1.Children’s SMPP is mainly preschool,and infants and youngchildren are not uncommon;2.The duration of fever was significantly prolonged in SMPP children,and the incidence was independent of gender.3.Calculate the corresponding cut value by ROC curve.Analysis shows that when CRP>25mg/L,IgG>8.85 g/L,IgM>8.85 g/L,LDH>375u/L Are important indicators for judging SMPP.4.SMPP is prone to extrapulmonary and intrapulmonary complications.Extrapulmonary complications are mainly myocardial damage,followed by digestive system involvement.The most common pulmonary complications are pleural effusion,followed by atelectasis.5.imaging studies suggest large solid shadow or pleural effusion,when the right lower lung is the main,you need to be alert to SMPP. |
