| 郭文婧,张悦,王艳芬,等.不同年龄组儿童肺炎支原体肺炎临床特点及重症危险因素分析[J].安徽医药,2026,30(11):2217-2222. |
| 不同年龄组儿童肺炎支原体肺炎临床特点及重症危险因素分析 |
| Clinical characteristics and risk factors for severe disease in children with mycoplasma pneumoniae pneumonia across different age groups |
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| DOI：10.3969/j.issn.1009-6469.2026.11.018 |
| 中文关键词: 肺炎支原体肺炎 儿童 临床特点 危险因素 |
| 英文关键词: Mycoplasmal pneumoniae pneumonia Children Clinical characteristic Risk factor |
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| 中文摘要: |
| 目的探讨不同年龄组儿童肺炎支原体肺炎( MPP)临床特点，并分析各年龄组儿童重症肺炎支原体肺炎( SMPP)相关危险因素。方法采用回顾性研究方法对 2024年 1―12月于山西白求恩医院儿科住院的 MPP病儿资料进行分析。按照年龄分为 <5岁组 163例及 ≥5岁组 651例，比较组间住院资料，分析各年龄组病儿临床特点；根据 2024年修订版儿童社区获得性肺炎重症标准分别将各年龄组病儿分为轻症组和重症组，比较组间住院资料，采用 logistic回归分析法分析各年龄组 SMPP的危险因素。结果 814例病儿中，男性 413例，女性 401例，男女比例为 1.03；<5岁组 MPP病儿女性居多( 56.4%)≥5岁组男性居多( 52.5%)，两组间差异有统计学意义( P<0.05)； <5岁组 MPP病儿与 ≥5岁组在发热比例［138例( 84.7%)比 602例(，92.5%)］、热持续时间［5(2，7)d比 6(4，7)d］、喘息发生率［26例( 16.0%)比 27例( 4.1%)］、湿啰音发生率［59例( 36.2%)比 171例发(26.3%)］、白细胞计数［8.4(6.3，10.4)×109/L比 7.2(5.9，8.9)×109/L］、中性粒细胞百分比［53.6(40.6，61.4)%比 63.5(56.8， 69.9)%］、中性粒细胞计数［4.04(2.86，5.93)×109/L比 4.47(3.50，5.80)×109/L］、淋巴细胞百分比［34.2(27.2，46.8)%比 24.8(19.8， 31.2)%］、淋巴细胞计数［2.78(1.97，3.80)×109/L比 1.74(1.39，2.23)×109/L］、中性粒细胞 /淋巴细胞［1.55(0.90，2.34)/2.56(1.81，3.53)］、血小板计数［283(228，344)×109/L比 252(211，301)×109/L］、 C反应蛋白［8.84(2.50，22.10)mg/L比 12.59(5.00，26.33)mg/L］、乳酸脱氢酶(LDH)［291.3(253.7，342.1)IU/L比 258.3(227.2，296.7)IU/L］、丙氨酸氨基转移酶［12.1(10.5，16.4)IU/L比 1.60(9.80，15.00)IU/L］方面比较差异有统计学意义(均 P<0.05)。多因素 logistic回归分析示， <5岁组 SMPP的独立危险因素为发热持续时间、呼吸音减低及 LDH；≥5岁组 SMPP的独立危险因素为发热持续时间、呼吸音减低及 D二聚体。结论不同年龄组 MPP病儿临床表现存在差异；发热持续时间长、呼吸音减低是全年龄组儿童 SMPP预警指标， LDH是低龄儿童 SMPP特异性预测指标， D-二聚体是年长儿童 SMPP特异性预测指标，对早期识别 SMPP具有重要临床价值。 |
| 英文摘要: |
| Objective To explore the clinical features of Mycoplasma pneumoniae pneumonia (MPP) in children of different agegroups and to identify the risk factors associated with severe MPP (SMPP) in each age group.Methods We conducted a retrospectiveanalysis of the medical records of children hospitalized for MPP at the Department of Pediatrics, Shanxi Bethune Hospital from Januaryto December 2024. The children were assigned to two groups: the <5-year-old group (n=163) and the ≥5-year-old group (n=651). A cross-group comparison of hospitalization data was performed to analyze the clinical characteristics of children in each age group. Ac-cording to the 2024 revised criteria for severe community-acquired pneumonia in children, patients in each age group were stratified in-to a non-severe group and a severe group. Comparative analysis of hospitalization data was performed, and logistic regression was em-ployed with the aim of identifying risk factors for SMPP within each age group.Results Among the 814 enrolled children, there were 413 males and 401 females, with a male-to-female ratio of 1.03:1. In the <5-year-old group, females accounted for the majority (56.4%), whereas males predominated in the ≥5-year-old group (52.5%). This difference in gender distribution between the two age groups was statistically significant (P<0.05). The comparison between the <5-year-old MPP group and the ≥5-year-old group demonstrated signifi-cant differences (all P<0.05) in the following parameters: the proportion of fever [138 (84.7%) cases vs. 602 (92.5%) cases], duration of fever [5(2,7) days vs. 6 (4,7) days], incidence of wheezing [26 (16.0%) cases vs. 27 (4.1%) cases], incidence of moist rales [59 (36.2%) cases vs. 171 (26.3%) cases], white blood cell count [8.4 (6.3, 10.4) ×10./L vs. 7.2 (5.9, 8.9) ×10./L], neutrophil percentage [53.6 (40.6, 61.4) % vs. 63.5 (56.8, 69.9) %], neutrophil count [4.04 (2.86, 5.93) ×10./L vs. 4.47 (3.50, 5.80)×10./L], lymphocyte percentage [34.2 (27.2, 46.8) % vs. 24.8 (19.8, 31.2) %], lymphocyte count [2.78 (1.97, 3.80) ×10./L vs. 1.74 (1.39, 2.23) ×10./L], neutrophil-to-lympho-cyte ratio [1.55 (0.90, 2.34) vs. 2.56 (1.81, 3.53)], platelet count [283 (228, 344) ×10./L vs. 252 (211, 301) ×10./L], C-reactive protein [8.84 (2.50, 22.10) mg/L vs. 12.59 (5.00, 26.33) mg/L], lactate dehydrogenase (LDH) [291.3 (253.7, 342.1) IU/L vs. 258.3 (227.2, 296.7) IU/L], and alanine aminotransferase (ALT) [12.1 (10.5, 16.4) IU/L vs. 11.6 (9.8, 15.0) IU/L] (all P<0.05). Multivariate logistic regressionanalysis identified prolonged fever duration, diminished breath sounds, and elevated LDH as independent risk factors for SMPP in the <5-year-old group. In the ≥5-year-old group, independent risk factors were prolonged fever duration, diminished breath sounds, and ele-vated D-dimer. Conclusions The clinical manifestations of MPP differ across age groups. Prolonged fever duration and diminished breath sounds serve as early-warning indicators for SMPP common to all pediatric patients. Specifically, elevated LDH levels constitutea distinctive predictive marker for SMPP in younger children, while elevated D-dimer levels represent a specific predictor for older chil-dren. These findings demonstrate significant clinical value for early identification of severe disease progression. |
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