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目的 探讨儿童肺炎支原体感染的临床特征及其与疾病严重程度的相关性，为早期识别重症感染提供循证依据。方法 选取2023年9月至2024年12月宿州市立医院收治的肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia, MPP)患儿为研究对象，根据病情严重程度分为轻症组和重症组，并纳入同期收治的非肺炎支原体感染的肺炎患儿为对照组。收集3组患儿的人口学资料、临床表现、实验室检查及影像学资料，采用采用单因素分析比较组间差异，将有统计学意义的变量纳入多因素Logistic回归模型，筛选重症MPP的独立危险因素，并应用受试者工作特征(receiver operating characteristic, ROC)曲线评估其预测效能。结果 共纳入209例患儿，其中轻症组111例，重症组48例，对照组50例。肺炎患儿整体以低龄儿童为主，重症组患儿年龄为4.00(2.00,5.00)岁，低于轻症组的5.00(4.00,7.00)岁，而与对照组的4.00(2.25,5.75)岁差异无统计学意义。MPP发病呈现秋冬季高发趋势。临床表现上，重症组患儿咳嗽(89.58%)及肺部湿啰音(47.92%)比例均显著高于轻症组及对照组(均P<0.05)。实验室指标方面，重症组患儿白细胞计数(white blood cell count, WBC)[11.88(10.84,13.32)×109/L]、C反应蛋白(C-reactive protein, CRP)[11.13(6.35,20.55) mg/L]及肝素结合蛋白(heparin-bindingprotein, HBP)[33.94(28.73,47.76)ng/mL]显著高于轻症组及对照组(均P<0.05)。多因素Logistic回归分析显示，WBC、CRP及HBP均为儿童重症MPP的独立危险因素。据此构建的联合预测模型Logit P=-5.314+0.280×WBC+0.061×CRP+0.029×HBP，其预测重症MPP的ROC曲线下面积为0.874。结论 WBC、CRP及HBP是评估儿童MPP严重程度的关键实验室指标，3者联合检测有助于早期识别和预警重症MPP的发生。
Abstract：Objective To investigate the clinical characteristics of Mycoplasma pneumoniae infection in children and their correlation with disease severity, providing evidence-based foundations for the early identification of severe infection. Methods Children diagnosed with Mycoplasma pneumoniae pneumonia(MPP) admitted to Suzhou Municipal Hospital from September 2023 to December 2024 were enrolled as the study subjects. They were divided into mild and severe groups according to disease severity. Concurrently, children with non-MPP pneumonia hospitalized during the same period were included as the control group. Demographic data, clinical manifestations, laboratory indicators, and imaging features were collected from the three groups. Univariate analysis was used to compare inter-group differences. Variables with statistical significance were incorporated into a multivariate Logistic regression model to identify independent risk factors for severe MPP, and the receiver operating characteristic(ROC) curve was applied to evaluate the predictive efficacy. Results A total of 209 children were included, comprising 111 cases in the mild group, 48 cases in the severe group, and 50 cases in the control group. Children with pneumonia were predominantly younger. The median age of children in the severe group was 4.00(2.00, 5.00) years, which was significantly lower than that in the mild group [5.00(4.00, 7.00) years], but showed no statistically significant difference compared to the control group [4.00(2.25, 5.75) years]. MPP onset exhibited a trend of high incidence in autumn and winter. Regarding clinical manifestations, the proportions of cough(89.58%) and pulmonary moist rales(47.92%) in the severe group were significantly higher than those in the mild group and the control group(all P<0.05). Concerning laboratory indicators, the levels of white blood cell count(WBC) [11.88(10.84, 13.32)×109/L], C-reactive protein(CRP) [11.13(6.35, 20.55) mg/L], and heparin-binding protein(HBP) [33.94(28.73, 47.76) ng/mL] in the severe group were significantly higher than those in the mild group and the control group(all P<0.05). Multivariate Logistic regression analysis showed that WBC, CRP, and HBP were all independent risk factors for severe MPP in children. The combined prediction model constructed based on these factors(Logit P =-5.314 + 0.280×WBC + 0.061×CRP + 0.029×HBP) yielded an area under the ROC curve of 0.874 for predicting severe MPP. Conclusion WBC, CRP, and HBP are key laboratory indicators for assessing the severity of MPP in children. The combined detection of these three factors facilitates the early identification and warning of severe MPP.
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基本信息:
中图分类号:R725.6
引用信息:
[1]何深,朱峰,王宗燕.儿童肺炎支原体感染的临床特征及其与疾病严重程度的相关性分析[J].传染病信息,2026,39(02):165-169+192.
基金信息:
2024年度安徽省卫生健康科研项目（AHWJ2024Ab0168）
2026-04-30
2026-04-30