标题：儿童支原体肺炎合并全身炎症反应综合征患儿危险因素指标及其相关性

      作者：李文斌，邢静，王艳飞，魏阿平，马文霞，曲海新，卢艳辉，李春梅，张兵    (张家口市河北北方学院附属第一医院小儿内科，河北 张家口 075000)

      卷次： 2018年29卷5期

      【摘要】 目的 探讨儿童支原体肺炎合并全身炎症反应综合征患儿的危险因素指标及其相关性。方法 选取河北北方学院附属第一医院2013年9月至2016年10月收治的儿童支原体肺炎患儿205例作为研究对象，其中支原体肺炎合并全身炎症反应综合征患儿95例作为观察组，支原体肺炎但不合并全身炎症反应综合征患儿110例作为对照组，并选择同期在我院进行体检的健康儿童80例作为健康组。比较三组入组时的一般资料、血糖和血清C反应蛋白(CRP)水平以及实验室检查相关指标，找出患儿危险因素指标，并进行多因素Logistics分析。结果 经过比较，观察组患儿体温(38.01±2.16)℃、心率(92.16±12.31)次/min、呼吸频率(23.61±3.16)次/min、肺炎严重指数(PSI)评分(65.16±7.29)分、血糖(9.75±1.63) mmol/L和血清CRP水平(75.13±12.18) mg/L均高于对照组和健康组，差异有统计学意义(P<0.05)；观察组PCO2、中性粒细胞计数、白细胞计数、NT-proBNP等实验室指标和对照组及健康组比较差异均有统计学意义(P<0.05)。通过对患儿相关因素进行分析，患儿住院时间、激素种类和疗程、抗菌药物种类和疗程、血浆白蛋白为支原体肺炎合并全身炎症反应综合征的危险因素，与患儿发病存在密切相关；经过Logistics分析住院时间、激素疗程、血浆白蛋白低于正常值为儿童支原体肺炎合并全身炎症反应综合征的危险因素。结论 对儿童支原体肺炎合并全身炎症反应综合征患儿应重视激素疗程、血浆白蛋白等危险因素，密切关注患儿血糖、血清CRP水平，对中性粒细胞、NT-proBNP等实验室指标进行定期监测。
      【关键词】 儿童；支原体肺炎；全身炎症反应综合征；危险因素；相关性
      【中图分类号】 R 【文献标识码】 A 【文章编号】 1003—6350（2018）05—0643—03

Risk factors and correlation analysis of children's mycoplasma pneumonia combined with systemic inflammatoryresponse syndrome.
LI Wen-bin, XING Jing, WANG Yan-fei, WEI A-ping, MA Wen-xia, QU Hai-xin, LU Yan-hui, LIChun-mei, ZHANG Bing. Department of Pediatrics, First Affiliated Hospital of Hebei North University, Zhangjiakou 075000,Hebei, CHINA
【Abstract】 Objective To explore the risk factors and correlation analysis of children's mycoplasma pneumoniacombined with systemic inflammatory response syndrome. Methods From September 2013 to October 2013, 205 chil-dren with mycoplasma pneumonia were selected as research objects, including 95 children combined with systemic in-flammatory response syndrome (the observation group) and 110 children not combined with systemic inflammatory re-sponse syndrome (the control group). During the same period, 80 healthy children in the hospital for physical examina-tion were selected as health group. The general data, blood sugar, serum C-reactive protein (CRP), and laboratory exami-nation indexes were compared between the three groups. The risk factors for mycoplasma pneumonia combined with sys-temic inflammatory response syndrome were found out, and multiple-factor Logistic regression analysis was performed.Results The children's temperature, heart rate, respiratory rate, the pneumonia severity index (PSI) score, blood glu-cose and serum CRP level were (38.01 ± 2.16)℃ , (92.16 ± 12.31) beats/min, (23.61 ± 3.16) breaths/min, (65.16 ± 7.29),(9.75±1.63) mmol/L, (75.13±12.18) mg/L in the observation group, which were significantly higher than those in thecontrol group and the healthy group (P<0.05). PCO2, neutrophile granulocyte count, white blood cell count, andNT-proBNP in the observation group were statistically significant from those in the control group and the healthy group(P<0.05). Correlation analysis showed that length of hospital stay, variety of hormones and treatment course, variety ofantibacterial drug and treatment course, as well as plasma albumin were the risk factors for mycoplasma pneumonia com-bined with systemic inflammatory response syndrome, which were closely associated with the onset of children. Multi-ple-factor Logistic regression analysis revealed that length of hospital stay, treatment course of hormones, and plasma al-bumin less than normal value were the risk factors for children's mycoplasma pneumonia combined with systemic in-flammatory response syndrome. Conclusion For children of mycoplasma pneumonia combined with systemic inflam-matory response syndrome, risk factors such as length of hospital stay, treatment course of hormones, and plasma albu-min less than normal value should be paid close attention to, and blood glucose, serum CRP level, neutrophile granulo-cyte, and NT-proBNP should be regularly monitored.
      【Key words】 Children; Mycoplasma pneumonia; Systemic inflammatory response syndrome; Risk factors; Corre-lation·论 著·doi:10.3969/j.issn.1003-6350.2018.05.016基金项目：河北省卫生厅科研基金(编号：20170789)