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中国住院儿童肺炎支原体肺炎并发症的危险因素:一项系统评价和荟萃分析

Risk factors for complications of Mycoplasma pneumoniae pneumonia in hospitalized children in China: a systematic review and meta-analysis.

作者信息

Wang Ziyu, Peng Yingying, Yang Shuo, Chen Zhe, Wang Huizhe, Li Huanmin, Li Xinmin

机构信息

First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.

National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300193, China.

出版信息

BMC Pediatr. 2024 Dec 18;24(1):810. doi: 10.1186/s12887-024-05279-9.

Abstract

BACKGROUND

Mycoplasma pneumoniae pneumonia (MPP) is a common respiratory disease in children. Some patients may develop long-term respiratory issues such as chronic cough and wheezing due to complications. These complications increase the health burden for children with MPP, highlighting the need to understand their risk factors in order to improve disease prognosis. This study aims to assess the risk factors for complications in hospitalized children with MPP in China.

METHODS

A comprehensive review of Chinese and English databases was conducted up to April 2024 to retrieve studies focusing on complications in hospitalized children with MPP. Pooled effect sizes were calculated using random-effects or fixed-effects models. Statistical analyses were performed using R software and RevMan 5.3.

RESULTS

This meta-analysis encompassed a total of 17 studies. We analyzed multiple risk factors associated with complications, including prolonged fever (OR: 3.79, aOR: 1.64), pleural effusion (OR: 3.71, aOR: 6.70), extensive lung infiltration (OR: 5.52, aOR: 3.57), ≥ 2/3 consolidation in a single lung lobe (OR: 4.29, aOR: 4.52), right upper lung lesion (OR: 4.84, aOR: 3.57), extrapulmonary manifestations (OR: 3.20, aOR: 1.89), hypoxemia (OR: 7.58, aOR: 12.43), delayed administration of glucocorticoids (OR: 7.93, aOR: 6.67), and delayed administration of macrolides (OR: 2.75, aOR: 3.84).

CONCLUSION

Hospitalized children with SMPP and RMPP may have a higher risk of complications, and it is important to identify risk factors early and provide appropriate treatment to minimize complications. The current level of evidence is relatively low and may not accurately reflect the actual clinical situation in China. Further high-quality studies are needed to validate and clarify these findings.

TRIAL REGISTRATION

Our protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42024534397).

摘要

背景

支原体肺炎(MPP)是儿童常见的呼吸道疾病。一些患者可能因并发症而出现慢性咳嗽和喘息等长期呼吸问题。这些并发症增加了MPP患儿的健康负担,凸显了了解其危险因素以改善疾病预后的必要性。本研究旨在评估中国住院MPP患儿并发症的危险因素。

方法

截至2024年4月,对中英文数据库进行全面检索,以获取关注住院MPP患儿并发症的研究。采用随机效应或固定效应模型计算合并效应量。使用R软件和RevMan 5.3进行统计分析。

结果

本荟萃分析共纳入17项研究。我们分析了与并发症相关的多个危险因素,包括发热时间延长(OR:3.79,校正OR:1.64)、胸腔积液(OR:3.71,校正OR:6.70)、广泛肺浸润(OR:5.52,校正OR:3.57)、单个肺叶≥2/3实变(OR:4.29,校正OR:4.52)、右上肺病变(OR:4.84,校正OR:3.57)、肺外表现(OR:3.20,校正OR:1.89)、低氧血症(OR:7.58,校正OR:12.43)、糖皮质激素延迟使用(OR:7.93,校正OR:6.67)以及大环内酯类药物延迟使用(OR:2.75,校正OR:3.84)。

结论

住院的重症MPP和难治性MPP患儿可能有更高的并发症风险,早期识别危险因素并提供适当治疗以尽量减少并发症很重要。目前的证据水平相对较低,可能无法准确反映中国的实际临床情况。需要进一步的高质量研究来验证和阐明这些发现。

试验注册

我们的方案已在国际前瞻性系统评价注册库(PROSPERO)中注册(注册号:CRD42024534397)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b15f/11654151/aad093d4fad3/12887_2024_5279_Fig1_HTML.jpg

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