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肺炎患儿塑料支气管炎的临床特征及危险因素分析

Analysis of Clinical Characteristics and Risk Factors of Plastic Bronchitis in Children With Pneumonia.

作者信息

Zhong Haiqin, Yin Rong, Zhao Ran, Jiang Kun, Sun Chao, Dong Xiaoyan

机构信息

Department of Respiratory Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Front Pediatr. 2021 Oct 18;9:735093. doi: 10.3389/fped.2021.735093. eCollection 2021.

Abstract

To analyze the clinical characteristics of plastic bronchitis (PB) in children with pneumonia (MPP) in order to explore its risk factors. A retrospective analysis was performed in MPP children receiving bronchoscopy admitted to department of respiratory medicine in Shanghai Children's Hospital from January 2018 to December 2020. According to the bronchoscopic findings, the patients were divided into PB group and non-PB group. The clinical manifestations, laboratory examination, etiology, treatment methods and outcomes of the children were analyzed. Logistic regression was used to analyze the risk factors for PB in children with MPP. A total of 296 children with MPP were enrolled in the study, including 42 (14.2%) children in the PB group and 254 (85.8%) children in the non-PB group. There was no difference in the ratios of gender, age, proportion of fever, cough, wet rales, and wheezing rales between the two groups ( > 0.05). The univariate analysis showed that there were significant differences between the PB group and the non-PB group in LDH, D-dimer, CD3+CD4+(%), CD3+CD4+/CD3+CD8+, CD3 count, CD4 count, CD8 count, complement 3, IL8, IL-1β, IL-2, IL-10 ( < 0.05). The multivariate logistic regression analysis showed that fever duration > 12 d, IL-8 > 2,721.33 pg/ml, LDH > 482 U/L and complement 3 <1.02 g/L were independent risk factors for PB in children with MPP. Children with PB caused by MPP have protracted fever, a strong inflammatory response and immune function disturbance.

摘要

分析肺炎支原体肺炎(MPP)患儿并发塑形支气管炎(PB)的临床特征,以探讨其危险因素。对2018年1月至2020年12月在上海儿童医学中心呼吸内科住院并接受支气管镜检查的MPP患儿进行回顾性分析。根据支气管镜检查结果,将患儿分为PB组和非PB组。分析患儿的临床表现、实验室检查、病因、治疗方法及转归。采用Logistic回归分析MPP患儿发生PB的危险因素。本研究共纳入296例MPP患儿,其中PB组42例(14.2%),非PB组254例(85.8%)。两组患儿的性别、年龄、发热、咳嗽、湿啰音及哮鸣音比例比较,差异均无统计学意义(>0.05)。单因素分析显示,PB组与非PB组在乳酸脱氢酶(LDH)、D-二聚体、CD3+CD4+(%)、CD3+CD4+/CD3+CD8+、CD3计数、CD4计数、CD8计数、补体3、白细胞介素8(IL-8)、白细胞介素1β(IL-1β)、白细胞介素2(IL-2)、白细胞介素10(IL-10)方面差异有统计学意义(<0.05)。多因素Logistic回归分析显示,发热持续时间>12 d、IL-8>2721.33 pg/ml、LDH>482 U/L及补体3<1.02 g/L是MPP患儿发生PB的独立危险因素。MPP所致PB患儿发热时间延长,炎症反应强烈,免疫功能紊乱。

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