| 张甜,黄冰,邹映雪,等.儿童肺炎衣原体肺炎合并气道黏液栓的危险因素分析[J].安徽医药,待发表. |
| 儿童肺炎衣原体肺炎合并气道黏液栓的危险因素分析 |
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| 投稿时间：2026-04-03 录用日期：2026-05-13 |
| DOI： |
| 中文关键词: 肺炎衣原体肺炎 儿童 黏液栓 支气管镜 危险因素 |
| 英文关键词: |
| 基金项目:基金项目：天津市自然科学基金（20JCZDJC00630）；天津市医学重点学科建设资助（TJYXZDXK-3-016B） |
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| 中文摘要: |
| 目的：探讨儿童肺炎衣原体肺炎（Chlamydia pneumoniae pneumonia，CPP）合并气道黏液栓形成的危险因素，为临床早期识别和干预提供依据。
方法：回顾性纳入2024年3月至2025年9月天津市儿童医院呼吸科收治的、确诊为CPP并接受支气管镜检查的70例患儿。根据支气管镜检查结果，将患儿分为黏液栓组与无黏液栓组。收集两组患儿的一般资料、临床表现、实验室指标、影像学特征及治疗方案。采用单因素分析及多因素Logistic回归分析探讨CPP合并气道黏液栓形成的独立危险因素。
结果：70 例CPP患儿中黏液栓组 32 例（45.7%），无黏液栓组 38 例（54.3%）。单因素分析显示，黏液栓组中性粒细胞比值、D-二聚体水平、≥2/3单肺叶实变及肺不张发生率均高于无黏液栓组（均 P<0.05），术前使用多西环素比例更低（P<0.05）；多因素 Logistic 回归分析表明，D 二聚体升高（OR=5.707，95%CI：1.195～27.250，P=0.029）、肺不张（OR=10.125，95%CI：1.061～96.615，P=0.044）是 CPP患儿气道黏液栓形成的独立危险因素。
结论：CPP患儿出现D-二聚体升高、影像学显示肺不张时，应高度警惕气道黏液栓形成的可能，对于此类患儿，应积极考虑早期行支气管镜干预，以改善预后。 |
| 英文摘要: |
| Objective:To investigate the risk factors for airway mucus plug formation in children withChlamydia pneumoniaepneumonia (CPP), and to provide evidence for early clinical identification and intervention.Methods:A retrospective analysis was conducted on 70 children diagnosed with CPP who underwent bronchoscopy at the Department of Respiratory Medicine, Tianjin Children"s Hospital, from March 2024 to September 2025. According to the bronchoscopic findings, the children were divided into a mucus plug group and a non-mucus plug group. General data, clinical manifestations, laboratory indicators, imaging features, and treatment regimens were collected for both groups. Univariate analysis and multivariate logistic regression analysis were used to identify independent risk factors for airway mucus plug formation in CPP.Results:Among the 70 children with CPP, 32 cases (45.7%) were classified into the mucus plug group and 38 cases (54.3%) into the non-mucus plug group. Univariate analysis showed that the mucus plug group had significantly higher neutrophil ratio, D-dimer level, incidence of consolidation involving ≥ two?thirds of a single pulmonary lobe, and incidence of atelectasis compared with the non-mucus plug group (allP< 0.05), while the proportion of preoperative doxycycline use was lower (P< 0.05).Multivariate logistic regression analysis revealed that elevated D-dimer level (OR=5.707,95%CI:1.195～27.250,P=0.029)and atelectasis (OR=10.125,95%CI:1.061～96.615,P=0.044)were independent risk factors for airway mucus plug formation in children with CPP.Conclusion:When children with CPP present with elevated D-dimer levels and imaging findings of atelectasis, the possibility of airway mucus plug formation should be highly suspected. For such patients, early bronchoscopic intervention should be actively considered to improve prognosis. |
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