The Studies On Severe Mycoplasma Pneumoniae Pneumonia And Pertussis In Children

Objects: To explore the risk factors of severe mycoplasma pneumoniae pneumonia in children through the retrospectively analysis of clinical datas of children with MPP,and to provide evidence for early diagnosis and early application of corticosteroide.Subjects and Methods : The clinical datas of 372 children of MPP adimitted to our hospital from October 2014 to October 2015 were collected,and divided them into SMPP group(84 cases)and non-SMPP group(237 cases).The risk factors associated with SMPP were studied by single factor analysis and multivariate logistic regression analysis.Results: Single factor analysis showed that age,fever time,C-reactive protein(CRP),ESR,LDH,high MP-Ab titers,high DNA copies,cellular immune disorders(IL-6/8/10,TNF-α),positive antibodies,the area of consolidation of the lung,the pleural effusion,extrapulmonary manifestations and complications were related to SMPP(P < 0.05).Multivariable Logistic regression analysis showed that fever time,CRP,LDH,high MP-Ab titers,positive antibodies,the area of consolidation of the lung,the pleural effusion,extrapulmonary manifestations and complicationswere the independent risk factors of SMPP(P < 0.05).Conclusions: Fever time,CRP,LDH,high MP-Ab drops,positive antibodies,the area of consolidation of the lung,the pleural effusion,extrapulmonary manifestations and complicationswere the independent risk factors of SMPP,and may be helpful to its early identification and to guide the application of glucocorticoid.Objects: Pertussis was caused by Bordetella pertussis.It used to seriously threaten the life safety and health of children.The use of Joint DPT Vaccine made its incidence decreased obviously.As the promotion of the DPT acellular vaccine,the safety of vaccination had improved significantly.In recent years,however,we found that the incidence of pertussis in children who had not yet been vaccinated had a tendency to increase.Reports showed that it might be related to the decrease of antibody levels in the crowd.The purpose of this cross sectional study was to estimate the intensity and duration of the DPT Vaccinebythe detection of Ig G antibodies against pertussis toxin in serum among children,and to provide scientific evidences for the development of vaccination protocol and assessing of vaccination effect.Subjects and Methods : Blood samples were obtained from 372 children aged 0-18?years old in Shanghai.The concentration of anti-PT Ig G in serum was determined by commercial ELISA kits.Subject with a concentration higher than30?IU/m L was indicated to have recent contaction with Bordetella pertussis,and higher than100?IU/m L was indicated an acute infection,if they had not received a pertussis vaccine in the past year.Results: Of the 372 subjects,42(11.29%)cases’ s concentration of anti-PT antibodies were found higher than 30?IU/m L,and the average concentration was 16.21 IU/m L.The peaks of the positive rate of antibodies in serum were found in age group of 0-2?years old(18.60%)and 10-12 years old(11.43%),and thethe lowest positive rate of was found in the 13–19?years old group(7.46%).The lowest average concentration of anti-PT antibodies was found in the group of 0-2?years old(21.82 IU/m L)and 10-12 years old(21.16 IU/m L),and the lowest group was the 6-9 years old(9.74 IU/m L).Conclusions: This study shows that B.pertussis infection is common among children in our country,and the highest incidence was found in age group of 10-12 years old.As high-risk groups of pertussis infection and the important source of infant pertussis infection,the employment of booster dose of pertussis vaccine may be useful in reducing the incidence of pertussis all ages of children.