| ObjectiveMycoplasma pneumoniae（MP）is one of the most important pathogens causing pneumonia in children.About 10% to 40% of hospitalized children with community-acquired pneumonia are infected with Mycoplasma pneumoniae.Mycoplasma pneumoniae pneumonia can be complicated by pleural effusion,necrotizing pneumonia,Skin and mucous membrane damage,nervous system damage,etc.,some children’s lung function will develop into mild obstructive or restrictive mode,and the prognosis is poor.In recent years,reports of Mycoplasma pneumoniae infection complicated with necrotizing pneumonia（MPNP）have gradually increased in China.It is reported that 58% to 69% of the pathogens in children with necrotizing pneumonia are Mycoplasma pneumoniae.Therefore,it is of great significance to explore the clinical related factors that affect children with Mycoplasma pneumoniae infection complicated with necrotizing pneumonia,which is of great significance for the estimation of the disease condition,the selection of treatment strategies and the judgment of prognosis.In this study,we retrospectively analyzed the clinical features and laboratory findings of Mycoplasma pneumoniae-infected necrotizing pneumonia group and non-necrotizing pneumonia group,aiming to find early indicators for predicting Mycoplasma pneumoniae necrotizing pneumonia and improve the identification of the disease.and therapeutic levels,improving prognosis.MethodsA retrospective analysis of the patients who were admitted to the Department of Respiratory Medicine,Shenyang Children’s Hospital from September 2019 to December 2021,were clinically diagnosed with Mycoplasma pneumoniae lobar pneumonia and had pulmonary necrosis changes on imaging studies were: Mycoplasma pneumoniae necrotizing pneumonia（MPNP）（30 cases）was used as the case group,and30 cases were diagnosed with Mycoplasma pneumoniae lobar pneumonia（MPLP）during the same period,and those without necrotizing changes on imaging were used as the control group.The medical histories of the two groups of children were compared,including: age,gender,length of hospital stay,heat duration（days）,heat peak（°C）,and the incidence of pleural effusion;laboratory test results: white blood cell count,neutrophil ratio,C-reactive protein,Lactate dehydrogenase,D-dimer,ferritin,and procalcitonin levels.SPSS26.0 statistical software was used for data processing.After univariate analysis,the ROC curve was further drawn for the indicators with statistically significant differences between groups.The difference was considered statistically significant at P<0.05.Results1.In the necrosis group and the control group,there was no statistical difference in gender and age between the two groups.（P≥0.05）.2.Compared with the control group,the length of hospital stay and heat course in the necrosis group were significantly prolonged（P < 0.05）.Children in necrosis group were more prone to pleural effusion damage（P< 0.05）.3.The leukocyte count,C-reactive protein,D-dimer,lactate dehydrogenase and ferritin in the necrosis group were significantly higher than those in the control group（P < 0.05）.4.Draw the ROC curve for predicting MPNP,the results show that when D-dimer>0.58μg/m L,lactate dehydrogenase>394IU/L,it has higher value for predicting the occurrence of MPNP（AUC=0.902,0.779,P<0.05）.Conclusions1.Compared with children with MPLP,children with MPNP have a longer course of disease and fever,and have more significant increases in peripheral blood white blood cell counts,C-reactive protein and other inflammatory indicators,and are more likely to have complications such as pleural effusion.2.When D-dimer>0.58μg/m L and lactate dehydrogenase>394IU/L,it is necessary to be alert to the occurrence of MPNP,and timely improvement of lung CT examination is conducive to early diagnosis,and active comprehensive treatment can improve prognosis. |
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