Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China.
Department of Laboratory Medicine, Department of Clinical Laboratory, Children's Hospital of Soochow University, Suzhou, China.
Clin Respir J. 2024 May;18(5):e13767. doi: 10.1111/crj.13767.
The aim of this study is to investigate the clinical characteristics and pathogens involved in persistent or recurrent pneumonia combined with airway malacia in children.
We retrospectively reviewed the information of children hospitalised with persistent or recurrent pneumonia, including clinical presentations, laboratory examination results and pathogens.
A total of 554 patients were admitted, 285 (51.44%) of whom were found to have airway malacia. There were 78 (27.37%), 166 (58.25%) and 41 (14.39%) patients with mild, moderate and severe malacia, respectively. Patients with airway malacia were younger than those without malacia (6.0 vs. 12.0 months, p < 0.01) and were more likely to present with wheezing (75.07%), fever (34.39%), dyspnoea (28.77%), cyanosis (13.68%) and wheezing in the lungs (78.95%). The incidence of preterm delivery, oxygen therapy, paediatric intensive care unit (PICU) admission and mechanical ventilation was higher, and the hospital stay (11.0 vs. 10.0 days, p = 0.04) was longer in these patients than in those without malacia. Patients with severe airway malacia were more likely to undergo oxygen therapy, PICU admission, mechanical ventilation and have multiple malacia than were those with mild or moderate malacia. Mycoplasma pneumoniae (30.18%) was the most common pathogen.
Severe airway malacia likely aggravates conditions combined with pneumonia. The proportion of multisite malacia was greater in severe airway malacia patients.
本研究旨在探讨伴有气道软化的持续性或复发性肺炎患儿的临床特征及病原体。
我们回顾性分析了因持续性或复发性肺炎住院的患儿的临床资料,包括临床表现、实验室检查结果和病原体。
共纳入 554 例患儿,其中 285 例(51.44%)存在气道软化。轻度、中度和重度气道软化分别为 78 例(27.37%)、166 例(58.25%)和 41 例(14.39%)。气道软化患儿的年龄小于无气道软化患儿(6.0 个月 vs. 12.0 个月,p<0.01),且更易出现喘息(75.07%)、发热(34.39%)、呼吸困难(28.77%)、发绀(13.68%)和肺部哮鸣音(78.95%)。早产、氧疗、儿童重症监护病房(PICU)入住和机械通气的发生率较高,住院时间(11.0 天 vs. 10.0 天,p=0.04)较长。重度气道软化患儿较轻度或中度气道软化患儿更易接受氧疗、PICU 入住、机械通气和存在多处气道软化。肺炎支原体(30.18%)是最常见的病原体。
重度气道软化可能使肺炎合并的病情加重。重度气道软化患儿多部位气道软化的比例更大。