Clinical Study On Risk Factors Of Chronic Cough In Children Suffering From Mycoplasma Pneumoniae Pneumonia

Objective To explore the risk factors of chronic cough in children suffering from Mycoplasma pneumoniae pneumonia(MPP),and to analyze the best cut-off value of related risk factors for predicting chronic cough caused by MPP.Methods This study collected a total of 151 children with MPP admitted to the Department of Pediatrics of Changde First People’s Hospital from September 2019 to November 2020.The relevant clinical indicators during hospitalization of all children were collected.The serum Mycoplasma pneumoniae(MP)antibody titer changes greater than or equal to 4 times in the acute and convalescent phases were used as the diagnostic criteria for MPP.The children were followed up by telephone when 4weeks after discharged.All children were divided into two group according to whether chronic cough occurred,a case group(26 cases)and a control group(125 cases),and relevant clinical indicators were collected.Binary logistic regression were performed on analyzing independent risk factors of chronic cough in children suffering from MPP,and obtaining the best cut-off value of relevant risk factors for predicting MPP-induced chronic cough by drawing ROC curve.Results 1.General information: Included in 151 children,80 females and 71 males,with an average age of(5.1±2.5)years.There were26 cases(17.2%)occurred chronic cough and 125 cases(82.8%)with no chronic cough.In the case group azithromycin began treatment time mainly in the more than 1 week(88.5%),while the control group distributed in 1week or less(76.0%);atomizing days mainly in one week or less(76.9%)after the patient group was discharged,the control The group atomization days were mainly distributed over 1 week(72.0%).The number of sequential treatment courses in the case group was mainly distributed below the number of low treatment courses(76.9%),while that in the control group was dominated by the number of high treatment courses(73.6%).2.Univariate analysis: Compared with the control group,the start time of azithromycin treatment,the number of sequential treatment courses,the days of nebulization treatment and LDH in the case group were statistically different(P<0.05);the two groups compare in age,gender,heat course,WBC,hs-CRP,Ig G,Ig M,Ig A,C3,C4,with not statistical difference(P>0.05);3.Binary Logistic regression: Start treatment time with azithromycin[OR=1.378,95%CI(1.145,1.658)],LDH[OR=1.013,95%CI(1.003,1.022)],number of high sequential treatment courses [OR=0.132,95%CI(0.026,0.680)],the number of days of nebulization treatment [OR=0.775,95%CI(0.614,0.977)] have independent effects on chronic cough caused by MPP(P<0.05);among them,the chronic cough caused by MPP was positively associated with the starting time of treatment with azithromycin and LDH,but negatively correlated with the number of sequential treatment courses and the number of days of nebulization treatment.4.ROC curve: The area under the curve of starting treatment time with azithromycin was 0.867,when the cut-off value was 6.5 days,with a sensitivity of 88.5% and a specificity of 80.0%.The area under the LDH curve is 0.794,when the intercept value is 346.5U/L,with a sensitivity of73.1% and a specificity of 86.4%.The area under the curve of the number of sequential treatment courses is 0.774,when the cut-off point is 1.5courses,with 76.9% the sensitivity and 73.6% specificity.The area under the curve of nebulization treatment days is 0.776.When the cut-off value is6.0 days,with a sensitivity of 76.9%and a specificity of 72.0%.Conclusion 1.The incidence of children with chronic cough caused by MPP in our hospital was 17.2%.2.The start time of azithromycin treatment,the number of days of nebulization treatment,the number of sequential treatment course,and LDH are independent risk factors for the development of chronic cough caused by MPP in children.3.Azithromycin treatment time,treatment days of nebulization,number of sequential treatment courses,and LDH have predictive value for the chronic cough caused by MPP in children.The cut-off values are 6.5d,6.0d,1.5 courses,and 346.5 U/L,respectively.