Study On Early Predictive Indexes And Clinical Features Of Severe Mycoplasma Pneumoniae Pneumonia In Children

Objective:Analyze the clinical features and cytokine levels of bronchoalveolar lavage fluid in children with Mycoplasma pneumoniae pneumonia,and explore the predictive indicators for early identification of severe Mycoplasma pneumoniae pneumonia.Method:To retrospectively analyze the hospitalization data of 24 children with mild MP pneumonia(MMPP)and 47 children with severe MP pneumonia(SMPP),including collecting the bronchoalveolar lavage fluid of the two groups of children for the determination of cytokine levels,comparing the differences between the two groups of children,and plotting ROC curve,looking for predictive indicators of severe MP pneumonia.Among them,the bronchoalveolar lavage fluid of 9 children with bronchial foreign bodies was selected as the normal control group to compare the cytokine levels.Result:There was no statistical difference between the two groups in gender and age(P>0.05);D-dimer,lactate-dehydrogenase(LDH),ferritin(FER),procalcitonin(PCT),i nterleukin-6(IL-6),C-reactive protein(CRP),and Percentage of neutrophils(NE%)in the SMPP group were significantly higher than those in the MMPP group(P<0.05);But there was no statistically significant difference between the two groups in the first white blood cell(WBC)and fibrinogen(FIB)comparison(P>0.05);the vitamin D content in the SMPP group was significantly lower than that in the MMPP group(P<0.05);In the comparison of cytokines,transforming growth factor-β(TGF-β)and interferon-γ(IFN-γ)in the SMPP group were significantly higher than those in the MMPP group(P<0.05),but alveolar Surfactant protein A(SPA)was lower than that of children in the MMPP group(P<0.05);there was no significant difference in IL-17 and alveolar surfactant protein D(SPD)between SMPP group and the MMPP group(P>0.05).After univariate analysis,the indicators with statistical differences between the two groups were further analyzed by multivariate logistic regression analysis,showing that CRP(OR=1.089,95%CI: 1.012～1.171),TGF-β(OR=1.021,95%CI):1.002～1.041),SPA(OR=0.989,95%CI: 0.982～0.997)are the risk factors for SMPP(P<0.05).Draw the ROC curve of CRP,TGF-β,and SPA predicting SMPP.The results show that CRP>17.13mg/L,TGF-β>109.31pg/m L,SPA<256.65pg/m L,which are of higher value for predicting SMPP(AUC=0.760,0.723,0.775,respectively),P<0.01).Conclusion:After infection with MP pneumonia,multiple inflammatory indicators in the body are significantly increased,and when CRP>17.13mg/L,TGF-β>109.31pg/ml,SPA<256.65pg/ml,be alert for SMPP.Objective:To compare the clinical characteristics of Mycoplasma pneumoniae pneumonia and adenoviral pneumonia in children.Method:Clinical data of 151 children with pneumonia admitted to our hospital from January 2019 to June 2019 were retrospectively analyzed,including 106 cases of Mycoplasma pneumoniae pneumonia(MP group)and 45 cases of adenoviral pneumonia(ADV group).The general conditions,clinical manifestations,laboratory results,pulmonary imaging,proportion of severe cases,respiratory support style and length of hospital stay were compared between two groups.Result:The MP group had shorter fever time compared to the ADV group(P<0.01);and the maximum temperature in the MP group was lower than the ADV group(P<0.01).In the comparison of shortness of breath,wet rales in the lungs,tri-concave sign,hypoxemia,the differences were all significant between two groups(all P<0.01).The WBC in the MP group was lower than that in the ADV group(P<0.01);the PCT,IL-6,LDH and 25-(OH)D3 levels in the MP group were lower than those in the ADV group(all P<0.05);while there was no significant difference in CRP levels between two groups(P>0.05).Pulmonary imaging in the MP group mainly involved unilateral lung,and the ADV group mainly involved bilateral lungs(P<0.01).There was no significant difference in pulmonary patchy exudation between two groups(P>0.05).There were30 patients(28.3%)with severe pneumonia in MP group and 33 patients(73.3%)in the ADV group(P<0.01).Twelve patients(11.3%)in the MP group were given non-invasive respiratory support,1 patient(0.9%)was given invasive respiratory support;while 31 patients(68.9%)were given non-invasive respiratory support in the ADV group,and 5 patients(11.1%)were given invasive respiratory support(P<0.01).The MP group had shorter hospital stays than ADV group(P<0.01).Conclusion:The conditions of disease are more severe,and length of hospital stay is longer in children with adenoviral pneumonia than those with Mycoplasma pneumoniae pneumonia.