Abstract: Objective To investigate risk factors and prognosis of mycoplasma pneumoniae pneumonia (MPP) associated with inflammatory tracheostenosis in children,so as to provide reference of prevention and treatment in children′s MPP. Methods Clinical data of 116 children diagnosed with MPP and treated with bronchoscopy from January 2018 to January 2020 in Yuying Children′s Hospital Affiliated to Wenzhou Medial University were analyzed.According to the results of bronchoscopy,children were divided into the inflammatory tracheostenosis group (n=53) and the normal group (n=63).Clinical manifestations,laboratory and radiological results,and treatment outcome were compared between the two groups.Multiple Logistic regression analysis was used to analyze risk factors of MPP associated with inflammatory tracheostenosis in children. Results Compared with normal group,the levels of CRP(Z=3.368) and LDH(t=4.102),lobar pneumonia(χ²=20.496),fever duration(Z=2.151),cough duration day(χ²=2.527),hospitalization time(t=2.432),hospitalization expenses(Z=2.733) were significantly higher in the inflammatory tracheostenosis group(P＜0.05).LDH≥411 U/L(OR=8.922,95%CI:2.982-26.695),CRP≥22.9 mg/L(OR=4.857,95%CI:1.530-15.414)and lobar pneumonia(OR=4.857,95%CI:1.530-15.414)were risk factors for MPP in children with inflammatory tracheostenosis. Conclusions CRP≥22.9 mg/L,LDH≥411 U/L and lobar pneumonia can be the risk factors for MPP in children with inflammatory tracheostenosis.MPP Children associated with inflammatory tracheostenosis have poor clinical outcome and should be early treated by bronchoscopy.

Key words: mycoplasma pneumoniae pneumonia, inflammatory tracheostenosis, risk factors, prognosis

摘要： 目的 探讨儿童肺炎支原体肺炎(MPP)并发气管炎性狭窄的危险因素及预后,为儿童MPP防治提供参考。方法 回顾分析2018年1月-2020年1月116例因MPP收住温州医科大学附属育英儿童医院且行气管镜检查的患儿。根据气管镜下表现分为气管炎性狭窄组(n=53)及气管非炎性狭窄组(n=63),比较两组临床表现、实验室结果、影像学表现、治疗转归等,采用多因素Logistic回归分析探讨儿童MPP并发气管炎性狭窄的危险因素。结果 气管炎性狭窄组CRP值(Z=3.368)、LDH值(t=4.102),大叶性肺炎(χ²=20.496)、总热程(Z=2.151)、咳嗽天数(χ²=2.527)、住院时间(t=2.432)、住院费用(Z=2.733)高于气管非炎性狭窄组,差异有统计学意义(P<0.05)。LDH≥411 U/L(OR=8.922,95%CI:2.982~26.695)、CRP≥22.9 mg/L(OR=4.857,95%CI:1.530~15.414)、胸片大叶性表现(OR=5.870,95%CI:1.627~18.862)为MPP并发气管炎性狭窄的独立危险因素(P<0.01)。结论 CRP≥22.9 mg/L,LDH≥411 U/L,胸片大叶性肺炎表现可作为儿童MPP并发气管炎性狭窄的危险因素。并发气管炎性狭窄的MPP患儿临床转归欠佳,早期进行支气管镜术,改善预后。

关键词: 肺炎支原体肺炎, 气管炎症性狭窄, 危险因素, 预后