徐州市学龄前期肺炎支原体感染流行病学特征调查及转归不良的影响因素分析-东南大学学报医学版

徐州市学龄前期肺炎支原体感染流行病学特征调查及转归不良的影响因素分析

单位：徐州医科大学附属医院儿科, 江苏徐州 221002

分类号：R375.2;R18

出版年·卷·期（页码）：2024·43·第六期（904-910）

摘要：

目的:调查徐州市学龄前期儿童肺炎支原体(MP)感染流行病学特征,并分析转归不良的影响因素。方法:回顾性分析2020年1月至2023年10月在本院接受住院治疗的3 771例学龄前期呼吸道感染患儿的临床资料,筛选MP感染患儿进行流行病学特征分析。根据MP感染患儿转归情况将其分为转归不良组和转归良好组,并比较两组一般资料。采用多因素Logistic回归分析学龄前期MP感染患儿转归不良的影响因素。结果:学龄前期呼吸道感染患儿中MP感染的有788例(占比20.90%),其中女童感染率高于男童(22.20%比19.27%),城镇感染率高于农村(22.86%比18.03%),不同季节中以冬季感染率最高(23.21%),不同发病类型中以肺炎感染率最高(31.62%)。788例学龄前期MP感染患儿转归不良226例,发生率为28.68%。共217对完成匹配,匹配后组间性别、年龄、入院时白细胞计数(WBC)、血红蛋白(Hb)水平、白蛋白(Alb)水平、使用糖皮质激素占比比较差异均无统计学意义(P＞0.05),转归不良组C-反应蛋白(CRP)水平、入院时重症占比、合并其他病原体感染占比、肺外并发症占比以及发热持续时间均高于或长于转归良好组(P＜0.05),入院时血小板计数(PLT)水平低于转归良好组(P＜0.05);经多因素Logistic回归分析显示,入院时重症、入院时PLT水平降低、入院时CRP水平升高、合并其他病原体感染、肺外并发症、发热持续时间延长均是学龄前期MP感染患儿转归不良的危险因素(OR值分别为4.289 、 0.715、 2.497、 2.591、 3.071、 2.389, P＜0.05)。结论:学龄前期患儿MP感染率逐年升高,以女童、城镇、冬季、肺炎感染为主,且重症、发热持续时间、PLT水平、CRP水平以及合并其他病原体感染、肺外并发症均是学龄前期MP感染患儿转归不良的影响因素。

Objective: To investigate the epidemiological characteristics of Mycoplasma pneumoniae(MP) infection in preschool children in Xuzhou city, and analyze the influencing factors of poor outcome. Methods: The clinical data of 3 771 preschool children with respiratory infections who received inpatient treatment in our hospital from January 2020 to October 2023 were retrospectively analyzed, and the epidemiological characteristics of MP infected children were screened for analysis. They were divided into poor outcome group and good outcome group according to the outcome of MP infection in children, and the general informations of the two groups were compared. The the influencing factors of poor outcome in preschool children with MP infection were analyzed by using multivariate Logistic regression method. Results: 788 cases(accounting for 20.90%) of MP in preschool children with respiratory infections. The infection rate of girls was higher than that of boys(22.20% vs 19.27%). The infection rate in urban areas was higher than that in rural areas(22.86% vs 18.03%). Winter(23.21%) had the highest infection rate in different seasons, and pneumonia(31.62%) had the highest infection rate among different types of diseases. The incidence of poor outcome in preschool children with MP infection was 28.68%(226/788). A total of 217 pairs were matched. After matching, there were no statistically significant differences in gender, age, white blood cell count(WBC), hemoglobin(Hb), albumin(Alb) levels at admission and the use of glucocorticoids between the groups(P>0.05). The C-reactive protein(CRP) level, proportion of severe cases at admission, proportion of concurrent infections with other pathogens, proportion of extrapulmonary complications, and duration of fever were all higher in the poor outcome group than those in the good outcome group(P<0.05), while the platelet count(PLT) level at admission was lower than that in the good outcome group(P<0.05). Multivariate Logistic regression analysis showed that severe illness at admission, decreased PLT levels at admission, increased CRP levels at admission, concurrent infections with other pathogens, extrapulmonary complications and prolonged fever duration were all risk factors for poor outcomes in preschool children with MP infections(OR values were 4.289, 0.715, 2.497, 2.591, 3.071, 2.389, P<0.05). Conclusion: The infection rate of MP in preschool children has been increasing year by year, mainly in girls, urban areas, winter and pneumonia. Severity, duration of fever, PLT level, CRP level, concomitant infections with other pathogens, extrapulmonary complications are all factors influencing poor outcome of preschool children with MP infection.

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