Analysis Of Risk Factors Of Mycoplasma Pneumoniae Infection Combined With Vascular Embolism In Children

Background and purposeMycoplasma pneumoniae(MP)is an important pathogen of human respiratory infection,with an incidence of more than 50%in community-acquired pneumonia(CAP)in children aged 5 years and older.The incidence rate of mycoplasma pneumoniae may be generally underestimated because most of the patients are mild after mycoplasma pneumoniae infection.Some infected persons may not go to the hospital for further diagnosis and treatment due to their mild symptoms.Although most of the patients with mycoplasma pneumoniae infection have mild clinical symptoms,there are still quite a lot of patients need to be hospitalized or even admitted to intensive care unit for treatment.The clinical manifestations of mycoplasma pneumoniae infection are various.In addition to the clinical symptoms of upper and lower respiratory tract,there are often symptoms of multiple systems involved outside the lung.Although mycoplasma pneumoniae infection with vascular embolism is relatively rare,it is a serious complication after mycoplasma pneumoniae infection.Early recognition of mycoplasma pneumoniae infection with vascular embolism is difficult,which often leads to delayed diagnosis,which not only increases the risk of respiratory system damage in children,but also increases the disability rate and mortality rate of children due to delayed treatment.Therefore,early recognition of risk factors related to vascular embolism and intervention measures may reduce the incidence of this complications,so as to reduce the morbidity and mortality of children.Therefore,we adopted case-control study method to analyze the clinical characteristics,laboratory and imaging findings of children with mycoplasma pneumoniae infection,and to explore the risk factors of children with mycoplasma pneumoniae infection and vascular embolism.Objects and methodsThe clinical data of 92 children with mycoplasma pneumoniae infection admitted to the department of pediatrics of the first affiliated hospital of zhengzhou university from January 2011 to February 2019 were retrospectively analyzed.The children were divided into two groups,namely the case group and the control group,according to whether they were complicated with vascular embolism.Among them,the children with mycoplasma pneumoniae infection combined with vascular embolism were case group,with a total of 23 cases.At the same time,the gender and age matched children with mycoplasma pneumoniae infection without vascular embolism were selected as the control group,with a total of 69 cases.The differences in clinical characteristics,laboratory and imaging results between the two groups were compared,and the risk factors of mycoplasma pneumoniae infection with vascular embolism in children were analyzed by multivariate logistic regression.Results1.Among the 92 cases,56 were males and 36 were females.Among them,there were 23 cases in the case group,including 14 males and 9 females,the age of onset was 61(45,97)(month).There were 69 patients in the control group,including 42 males and 27 females,the age of onset was 70(50.5,100.5)(month).2.Among the 23 children with vascular embolism,16 cases were cerebral embolism,1 case was cerebral venous sinus thrombosis,1 case was left radial artery embolism with splenic infarction,2 cases were lower extremity artery embolism,2 cases were lower extremity vein embolism,1 case was pulmonary artery embolism with lower extremity vein embolism.3.The gender,age,thermal process,platelet count,prothrombin time,ratio of international standardized,prothrombin time,partial prothrombin time,glutamic pyruvic transaminase,glutamic oxaloacetylase,procalcitonin,ESR,serum IgE,C-reactive protein is greater than 50mg/L,chest imaging whether merger atelectasis,whether with pulmonary consolidation,whether merger pleural effusion were involved in the two groups,there were no significant difference(P>0.05).4.The hospitalization time,peripheral blood leukocyte count,proportion of neutrophils,absolute value of neutrophils,prothrombin time activity,fibrinogen,D-dimer,lactate dehydrogenase were more than 2 times of the upper limit of normal,multiple lobes or double lungs were involved in the two groups,the differences were statistically significant(P<0.05).5.The correlation analysis of the factors with statistically significant differences in clinical data between the two groups showed that the peripheral blood leukocyte count was related to the proportion of neutrophils and the absolute value of neutrophils,and the prothrombin time activity was related to D-dimer.Therefore,only the absolute value of neutrophils,fibrinogen,D-dimer,multiple lobed or double lung involvement were analyzed by logistic regression analysis.The results showed that the absolute value of neutrophils,fibrinogen,D-dimer,multiple lobed or double lung involvement were related to the incidence of Mycoplasma pneumoniae infection and vascular embolism in children(P<0.05).Conclusion1.Children with mycoplasma pneumoniae infection can be combined with vascular embolism,which is mostly cerebrovascular embolism.2.Increased absolute value of neutrophils in peripheral blood,increased d-dimer level,and the involvement of multiple lobes or lungs are related to the occurrence of mycoplasma pneumoniae infection with vascular embolism in children,which are the risk factors of mycoplasma pneumoniae infection with vascular embolism.