安徽医科大学学报2026，Vol.61Issue(1)：75-82,8.DOI:10.19405/j.cnki.issn1000-1492.2026.01.012
基于影像学和临床严重度分类的2054例儿童肺炎支原体肺炎的临床特征及危险因素研究
Clinical characteristics and risk factors of 2054 cases of mycoplasma pneumoniae pneumonia in children based on imaging and clinical severity classification
摘要
Abstract
Objective To investigate the clinical characteristics and risk factors of Mycoplasma pneumoniae pneu-monia(MPP)in children based on a dual classification integrating imaging features and clinical severity.Meth-ods Medical records of 2 054 pediatric patients with MPP were retrospectively analyzed.The cohort was stratified into severe consolidation(n=253),severe non-consolidation(n=118),non-severe consolidation(n=393),and non-severe non-consolidation groups(n=1 290)based on clinical and radiological findings.Inter group data and characteristics were compared and multiple regression analysis was conducted to construct a prediction model for se-vere consolidation group.Results Significant differences were observed among the groups in terms of age,dura-tion of fever,length of hospital stay,presence of pulmonary rales,inflammatory markers[C-reactive protein(CRP)and lactate dehydrogenase(LDH)],the use of hormones,and bronchoscopic treatment(all P<0.05).Compared with the severe non-consolidation group,non-severe consolidation group,and non-severe non-consolidation group,children in severe consolidation group exhibited the longest duration of fever[8(6,11)days vs 6(2,9),7(6,9)and 6(3,8)days,respectively]and the longest length of hospital stay[7(5,8)days vs 6(5,8),6(5,8)and 6(4,7)days,respectively].They also had the highest incidence of reduced breath sounds[34 cases(13.4%)vs 2 cases(1.7%),29 cases(7.4%)and 13 cases(1.0%),respectively]and a substan-tially higher rate of coinfections,particularly viral infections[63 cases(24.9%)vs 23 cases(19.5%),60 cases(15.3%)and 190 cases(14.7%),respectively].Multivariate analysis indicated that the independent risk factors for severe MPP(SMPP)were age>4.5 years,length of hospital stay>6.5 days,reduced breath sounds,neutrophil-to-lymphocyte ratio(NLR)>1.66,LDH>370.5 U/L,CRP>9.5 mg/L,and coinfection with vi-ruses.Reduced breath sounds(OR=5.58,95%CI:2.45-12.69)and coinfection with bacteria(OR=3.11,95%CI:1.43-6.75)were identified as the most significant risk factors for pulmonary consolidation in non-severe MPP children.Additionally,reduced breath sounds,coinfection with viruses,LDH>365.5 U/L,and CRP>32.1 mg/L were risk factors for severe pneumonia in children with pulmonary consolidation.For non-consolidation MPP children,the presence of pulmonary dry rales(OR=2.28,95%CI:1.46-3.56)was the primary indepen-dent risk factor for the development of severe pneumonia.Conclusion The chest imaging findings of MPP are asso-ciated with clinical severity,and the risk factor model constructed based on this imaging-clinical classification can assist in achieving precise hierarchical diagnosis and treatment in clinical practice.关键词
儿童/肺炎支原体肺炎/重症肺炎支原体肺炎/影像学分类/肺实变/混合感染/呼吸音减低Key words
children/mycoplasma pneumoniae pneumonia/severe mycoplasma pneumoniae pneumonia/imaging classification/pulmonary consolidation/co-infection/decreased breath sounds分类
医药卫生引用本文复制引用
李娇,周建涛,哈庆旭,霍绍虎,丁俊丽..基于影像学和临床严重度分类的2054例儿童肺炎支原体肺炎的临床特征及危险因素研究[J].安徽医科大学学报,2026,61(1):75-82,8.基金项目
安徽省卫生健康科研项目(编号:AHWJ2023A30008) （编号:AHWJ2023A30008）
安徽医科大学基础与临床合作研究提升计划项目(编号:2020xkjT027) （编号:2020xkjT027）
2022年安徽医科大学第一附属医院博士人才科研经费项目(编号:1550) Health Research Project of Anhui Province(No.AHWJ2023A30008) （编号:1550）
Basic and Clinical Col-laborative Research Enhancement Project of Anhui Medical University(No.2020xkjT027) （No.2020xkjT027）
Research Funding for PhD Talent in the First Affiliated Hospital of Anhui Medical University(No.1550) （No.1550）
