新医学2026，Vol.57Issue(6)：670-677,8.DOI:10.12464/j.issn.0253-9802.2025-0379
儿童社区获得性肺炎肺外并发症早期预警指标研究进展
Research progress on early warning of extrapulmonary complications in pediatric community-acquired pneumonia
摘要
Abstract
Pediatric community-acquired pneumonia(CAP)is a major infectious disease threatening global child health.Its extrapulmonary complications can involve multiple systems,including the digestive,neurological,cardiovascular,hematological,and skin/mucous membrane systems,significantly increasing the risk of progression to severe illness and even death.The pathogenesis of extrapulmonary complications in pediatric CAP is complex and diverse,involving direct pathogen invasion,immune-mediated injury,inflammatory cytokine storm,and microcirculatory disorders,among which the interaction between immunity and inflammation is a core link.The pathogenic mechanisms vary among different pathogens,and the mutual promotion of immune-mediated injury and inflammatory cytokine storm is a central pathological process leading to multisystem extrapulmonary complications in severe CAP.Among digestive system complications,liver injury is the most common,with warning indicators including IL-1>28.35 pg/mL,IL-6>24.9 pg/mL,and CRP>34.6 mg/L,while specific indicators exist for different pathogens(e.g.,Mycoplasma pneumoniae,Chlamydia psittaci).Regarding nervous system complications,encephalitis,encephalopathy,and epileptic seizures are frequently observed,with warning indicators including neurofilament light chain(NFL),cerebrospinal fluid lactate,D-dimer,and lymphocyte count.Cardiovascular system complications are dominated by myocardial injury(incidence approximately 30.1%),with warning indicators including IL-6≥258.64 pg/mL,CRP≥14.27 mg/L,and NLR≥2.41;novel biomarkers such as sST2 and cfDNA also have value.Severe hematological complications,such as disseminated intravascular coagulation(DIC)and hemophagocytic lymphohistiocytosis(HLH),have warning indicators including LAR≥8.08 and triglycerides>3.02 mmol/L.Skin and mucous membrane lesions are mostly associated with Mycoplasma pneumoniae infection,presenting as rash and mucositis.At present,the warning indicators still require validation through multicenter studies with large samples,and most studies focus on Mycoplasma pneumoniae.In the future,comparative studies on complications caused by multiple pathogens and multi-omics research should be strengthened to establish a standardized assessment system.关键词
儿童/社区获得性肺炎/肺外并发症/病理机制/危险因素Key words
Pediatrics/Community-acquired pneumonia/Extrapulmonary complications/Pathological mechanism/Risk factors引用本文复制引用
王婉玲,邓昱..儿童社区获得性肺炎肺外并发症早期预警指标研究进展[J].新医学,2026,57(6):670-677,8.基金项目
重庆市自然科学基金(CSTB2025NSCQ-GPX0369) （CSTB2025NSCQ-GPX0369）
