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支原体肺炎患儿临床严重程度、细菌载量与炎症反应的相关性

Correlation Between the Clinical Severity, Bacterial Load, and Inflammatory Reaction in Children with Mycoplasma Pneumoniae Pneumonia.

作者信息

Zhang Chen, Zhang Qiao, Du Jie-Lin, Deng Dan, Gao Ye-Lei, Wang Cheng-Lin, Zhao Hong-Jie, Guo Qian, Fu Zhou, Tian Dai-Yin

机构信息

Department of Pulmonology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, 400014, China.

出版信息

Curr Med Sci. 2020 Oct;40(5):822-828. doi: 10.1007/s11596-020-2261-6. Epub 2020 Oct 29.

Abstract

Given the lack of defining features in the clinical manifestations and radiographic findings for children with mycoplasma pneumoniae pneumonia (MPP), quantitative polymerase chain reaction (qPCR) has become a useful diagnostic method. This study was performed to explore the relationship between the qPCR findings, clinical symptoms, and inflammatory markers in children with MPP. Four hundred children with MPP have been enrolled in this retrospective analysis. All clinical and analytical information, including mycoplasma pneumoniae (MP) PCR results, has been collected. Based on the PCR results, the patients were divided into groups with load values (copy number) < 10 (54 cases), ≥10 and <10 (71 cases), ≥10 and <10 (112 cases), ≥10 and ≤10 (114 cases), and >10 (49 cases). The clinical features (including symptoms and signs) and inflammatory indicators were compared among the groups. The incidence of high fever (above 39°C), thermal peak during the entire hospitalization period, fever duration, days of hospitalization, and plasma lactate dehydrogenase (LDH) levels were statistically correlated with the MP PCR load value in children with MPP. The analysis of relevance degree showed the correlative order as a thermal peak of hospitalization > duration of fever > period of hospitalization > LDH value > C-reactive protein value. The host immune response was significantly greater in the complication group than in the non-complication group.

摘要

鉴于支原体肺炎(MPP)患儿的临床表现和影像学检查结果缺乏特征性,定量聚合酶链反应(qPCR)已成为一种有用的诊断方法。本研究旨在探讨MPP患儿qPCR结果、临床症状和炎症标志物之间的关系。本回顾性分析纳入了400例MPP患儿。收集了所有临床和分析信息,包括肺炎支原体(MP)PCR结果。根据PCR结果,将患者分为负荷值(拷贝数)<10(54例)、≥10且<10(71例)、≥10且<10(112例)、≥10且≤10(114例)和>10(49例)的组。对各组的临床特征(包括症状和体征)及炎症指标进行比较。MPP患儿高热(体温高于39°C)的发生率、整个住院期间的体温峰值、发热持续时间、住院天数及血浆乳酸脱氢酶(LDH)水平与MP PCR负荷值存在统计学相关性。相关性分析显示相关顺序为住院体温峰值>发热持续时间>住院时间>LDH值> C反应蛋白值。并发症组的宿主免疫反应明显高于非并发症组。

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