新医学2025，Vol.56Issue(4)：379-385,7.DOI:10.12464/j.issn.0253-9802.2024-0388
儿童肺炎支原体肺炎进展为塑型性支气管炎的危险因素
Risk factors of the progression of Mycoplasma pneumoniae pneumonia into plastic bronchitis in children
摘要
Abstract
Objective To analyze the clinical characteristics of children with Mycoplasma pneumoniae pneumonia(MPP)who progress into plastic bronchitis(PB)and identify the associated risk factors.Methods A total of 387 children diagnosed with MPP who underwent bronchoscopy were included in the study.They were divided into the MPP progressing into PB group and the MPP group based on the presence of plastic bronchial casts observed under microscopy.Clinical characteristics between two groups were compared,and the risk factors of the progression into PB were analyzed.Results The imaging findings,particularly from chest CT scans,revealed a higher incidence of atelectasis,lung necrosis,massive pleural effusion,bronchial stenosis or bronchial occlusion in the MPP progressing to PB group.Similarly,the occurrence of mixed infections,the levels of neutrophil percentage,lymphocyte percentage,neutrophil-to-lymphocyte ratio(NLR),procalcitonin,C-reactive protein and lactate dehydrogenase(LDH)in the MPP progressing into PB group were significantly higher than those in the MPP group(all P<0.05).Multivariate logistic regression analysis demonstrated that NLR>3.15 ng/L[OR(95%CI)=2.084(1.155,3.759)],LDH levels>408.5 U/L[OR(95%CI)=3.469(1.797,6.696)],imaging changes[OR(95%CI)=2.707(1.241,5.907)],and mixed infections[OR(95%CI)=4.517(2.201,9.271)]were the independent risk factors of MPP progressing into PB.Conclusions Characteristic imaging changes,mixed infections,and elevated levels of LDH and NLR are the independent risk factors for the progression of MPP into PB.Early identification of these factors by clinicians can enable prompt intervention.关键词
肺炎支原体肺炎/塑型性支气管炎/炎症指标/乳酸脱氢酶/中性粒细胞与淋巴细胞比率Key words
Mycoplasma pneumoniae pneumonia/Plastic bronchitis/Inflammation index/Lactate dehydrogenase/Neutrophil-to-lymphocyte ratio引用本文复制引用
李莉,孔程祥,闫睿,许锦姬..儿童肺炎支原体肺炎进展为塑型性支气管炎的危险因素[J].新医学,2025,56(4):379-385,7.基金项目
国家自然科学基金(82101804) （82101804）
深圳市宝安区医疗卫生基础研究项目(2020JD036) （2020JD036）
深圳市宝安区引进高层次医学团队项目(202404) （202404）
