Liver Damage In Children With Mycoplasma Pneumoniae Pneumonia

Objective: To explore the risk factors of liver damage in children with Mycoplasma pneumoniae pneumonia.Methods:1.The clinical data of 217 children with Mycoplasma pneumoniae pneumoniae pneumonia(MPP)admitted to Linquan County People’s Hospital from January 2020 to August 2022 were collected to analyze the high risk factors of Mycoplasma pneumoniae pneumonia complicated with liver function damage.Including general information(sex,age,length of hospital stay,onset season,heat peak,heat duration,the time of initiation of Macrolide administration,duration of steroid administration),laboratory indicators(blood routine,c-reactive protein,blood biochemistry,myocardial zymogram),imaging findings(whether there is consolidation of the lung,whether there are multiple lung lobes,whether there is atelectasis,and Whether concurrent pleural effusion).2.The children with MPP were divided into the liver damage group(107 cases)and non-liver damage group(110 cases)according to whether or not combined with liver function damage.The clinical characteristics of the two groups were compared: general data,laboratory indexes,imaging findings.The risk factors between the two groups were first analyzed by single factor analysis,then the significant variables were analyzed by multivariate logistic regression analysis to explore the high-risk factors of liver damage in children with Mycoplasma pneumoniae pneumonia,and finally the best cutoff value was obtained by analyzing the relevant factors with the ROC curve,Summarize the early predictors of liver damage in children with Mycoplasma pneumoniae pneumonia.Results:1.In total,107 of 217 Mycoplasma pneumoniae with pneumonia had liver damage.Univariate analysis between the liver damage group and non-liver damage group showed that the length of hospital stay,heat duration,heat peak(≥39.0 ° C),duration of hormone application,percentage of lymphocyte(LYM%),red blood cell distribution width(RDW),hemoglobin(HB),c-reactive protein(CRP),alkaline phosphatase protein(ALP),total protein(TP),albumin(Alb),lactate dehydrogenase(LDH),creatine kinase isoenzyme(CKMB),α-hydroxybutyrate dehydrogenase(α-HBDH),pulmonary consolidation,and involved in ≥ 2 pulmonary lobes,the difference was statistically significant(P<0.05).2.Further multivariate logistic regression analysis showed that the heat duration,heat peak(≥39.0°C),LYM%,RDW,LDH,and pulmonary imaging manifestations of ≥ 2pulmonary lobes involved in pulmonary lesions were independent risk factors for liver damage in children with Mycoplasma pneumoniae pneumonia(OR=1.197、2.526、1.038、1.568、1.014、2.935,P<0.05).3.The critical values of ROC curve were heat duration≥5.5 days,RDW≥12.75%、LDH≥298U/L,and the area under the curve(AUC)of the heat duration,RDW and LDH for the forecast of liver damage in children with Mycoplasma pneumoniae pneumonia was 0.700,0.713,0.809.Conclusion: When the fever course of children with Mycoplasma pneumoniae pneumonia occurred for 5.5 days,the heat peak ≥39.0 ° C,LDH ≥298U/L,RDW≥12.95%,and the lung lesion involving the lobes ≥2 were the independent risk factors of children with Mycoplasma pneumoniae pneumonia complicated with liver damage.In clinical practice,pediatricians should pay attention to the above indexes and factors,raise their vigilance to the liver damage caused by Mycoplasma pneumoniae pneumonia in children,avoid misdiagnosis and missed diagnosis,and take treatment measures in time.