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儿童支原体肺炎合并胸腔积液的临床特征及预测因素分析

Clinical Characteristics and Predictive Factors Analysis of Mycoplasma Pneumoniae Pneumonia Complicated with Pleural Effusion in Children.

作者信息

Ji Lianlian, Lin Liqun, Ye Jian, Li Zhishu

机构信息

Department of Pediatrics, The Third Affiliated Hospital of Wenzhou Medical University, Ruian, Zhejiang, China.

Department Radiography, Ruian Maternal and Child Health Hospital, Ruian, Zhejiang, China.

出版信息

Iran J Allergy Asthma Immunol. 2025 Jun 26;24(4):451-461.

Abstract

Mycoplasma pneumoniae pneumonia (MPP) is a prevalent cause of respiratory infections in children, sometimes leading to pleural effusion (PE). This study aimed to identify risk factors and clinical features associated with PE in pediatric MPP patients. We conducted a retrospective case-control study involving 412 children with MPP and 82 with MPP+PE at the Third Affiliated Hospital of Wenzhou Medical University from January 2021 to January 2024. Demographic, clinical, and laboratory data were analyzed using multivariate logistic regression and receiver operating characteristic (ROC) curves. Significant findings included a higher incidence of immunocompromised states in the MPP+PE group (18.29% vs. 8.98%). At admission, children with MPP+PE exhibited higher respiratory rates (29.94 vs. 29.16 breaths/min), lower oxygen saturation (82.33% vs. 83.14%), longer fever duration (5.75 vs. 4.83 days), elevated white blood cell counts (WBC) (11.64×10^9/L vs. 10.12×10^9/L), and increased erythrocyte sedimentation rates (ESR) (20.66 vs. 19.49 mm/h). Patients with PE also experienced longer antibiotic treatment (9.14±4.91 vs. 7.46±3.29 days) and extended hospital stays (13.58±4.18 vs. 12.37±3.52 days). Multivariate analysis identified several significant predictors of PE, and a joint prediction model achieved an area under the curve (AUC) of 0.842, sensitivity of 0.796, and specificity of 0.793. These findings suggest that specific clinical and laboratory factors can help identify children at higher risk for PE, facilitating timely interventions.

摘要

支原体肺炎(MPP)是儿童呼吸道感染的常见病因,有时会导致胸腔积液(PE)。本研究旨在确定小儿MPP患者发生PE的危险因素和临床特征。我们进行了一项回顾性病例对照研究,纳入了2021年1月至2024年1月在温州医科大学附属第三医院就诊的412例MPP患儿和82例MPP合并PE患儿。使用多因素逻辑回归和受试者工作特征(ROC)曲线分析人口统计学、临床和实验室数据。重要发现包括MPP合并PE组免疫功能低下状态的发生率更高(18.29%对8.98%)。入院时,MPP合并PE的儿童呼吸频率更高(29.94对29.16次/分钟),血氧饱和度更低(82.33%对83.14%),发热持续时间更长(5.75对4.83天),白细胞计数(WBC)升高(11.64×10^9/L对10.12×10^9/L),红细胞沉降率(ESR)增加(20.66对19.49mm/h)。发生PE的患者抗生素治疗时间也更长(9.14±4.91对7.46±3.29天),住院时间延长(13.58±4.18对12.37±3.52天)。多因素分析确定了PE的几个重要预测因素,联合预测模型的曲线下面积(AUC)为0.842,灵敏度为0.796,特异度为0.793。这些发现表明,特定的临床和实验室因素有助于识别发生PE风险较高的儿童,便于及时进行干预。

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