Lee Eun, Lee Yun Young
Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju 61469, Korea.
Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju 61469, Korea.
J Clin Med. 2021 Mar 10;10(6):1154. doi: 10.3390/jcm10061154.
The prevalence of refractory (MP) pneumonia is increasing. The present study aimed to identify the predictive factors of responses to treatment of MP pneumonia in children. A total of 149 children were diagnosed with MP pneumonia, of whom 56 were included in the good response group, 75 children in the slow response group, and 18 children in no response or progression group. Data on the clinical, laboratory, and radiologic features were retrospectively obtained through medical chart reviews. The severity of pneumonia, based on the extent of pneumonic lesions on chest x-ray (adjusted odds ratio (aOR), 10.573; 95% confidence intervals (CIs), 2.303-48.543), and lactate dehydrogenase (LDH) levels (aOR, 1.002; 95% CIs, 1.000-1.004) at the time of admission were associated with slow response to treatment of MP pneumonia. Pleural effusion (aOR, 5.127; 95% CIs, 1.404-18.727), respiratory virus co-infection (aOR, 4.354; 95% CIs, 1.374-13.800), and higher LDH levels (aOR, 1.005; 95% CIs, 1.002-1.007) as well as MP-specific IgM titer (aOR, 1.309; 95% CIs, 1.095-1.564) were associated with no response or progression of MP pneumonia. The area under the curve for the prediction of no or poor response in MP pneumonia using pleural effusion, respiratory virus co-infection, LDH levels, and MP-specific IgM titer at the time of admission was 0.8547. This study identified the predictive factors of responses to treatment of MP pneumonia in children, which would be helpful in establishing a therapeutic plan and predicting the clinical course of MP pneumonia in children.
难治性支原体（MP）肺炎的患病率正在上升。本研究旨在确定儿童MP肺炎治疗反应的预测因素。共有149名儿童被诊断为MP肺炎，其中56名儿童被纳入良好反应组，75名儿童被纳入反应缓慢组，18名儿童被纳入无反应或病情进展组。通过病历回顾回顾性获取临床、实验室和放射学特征数据。入院时基于胸部X线肺炎病变范围的肺炎严重程度（调整优势比（aOR），10.573；95%置信区间（CI），2.303 - 48.543）和乳酸脱氢酶（LDH）水平（aOR，1.002；95% CI，1.000 - 1.004）与MP肺炎治疗反应缓慢相关。胸腔积液（aOR，5.127；95% CI，1.404 - 18.727）、呼吸道病毒合并感染（aOR，4.354；95% CI，1.374 - 13.800）、较高的LDH水平（aOR，1.005；95% CI，1.002 - 1.007）以及MP特异性IgM滴度（aOR，1.309；95% CI，1.095 - 1.564）与MP肺炎无反应或病情进展相关。使用入院时的胸腔积液、呼吸道病毒合并感染、LDH水平和MP特异性IgM滴度预测MP肺炎无反应或反应不佳的曲线下面积为0.8547。本研究确定了儿童MP肺炎治疗反应的预测因素，这将有助于制定治疗方案并预测儿童MP肺炎的临床病程。
