The Clinical Characteristics and Predictors of Refractory Mycoplasma pneumoniae Pneumonia in ChildrenReportar como inadecuado




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Objective

To analyze the clinical characteristics of refracory Mycoplasma pneumoniae pneumonia RMPP, and explore the related factors predicting RMPP.

Methods

Retrospective analysis was performed on 634 children with Mycoplasma pneumoniae pneumonia MPP hospitalized in our hospital between January 1, 2011 and December 31, 2014. The clinical features, laboratory data, radiological findings between the RMPP group and the general Mycoplasma pneumoniae pneumonia GMPP group were compared and the predictive values of related factors were analyzed.

Results

The median age of the RMPP patients n = 145 was much older than that of the GMPP patients n = 489 P<0.01. We also found more severe presentations, higher incidence of extra-pulmonary complications and more serious radiological findings in RMPP group, which needed oxygen more often, longer antibiotics administration and intensive care P<0.05. Meanwhile, the levels of C-reactive protein CRP, lactic dehydrogenase LDH, immunoglobulin A IgM, interleukin IL-6, IL-10, interferon gamma IFN-γ and the percentage of neutrophils, CD8+ in RMPP group were significantly higher than those in GMPP group P<0.05; while the levels of prealbumin PAB were lower than that in GMPP group P<0.01. In ROC curve analysis, the percentage of neutrophil, CRP, LDH, PAB, IL-6, IL-10 and IFN-γ were useful for differentiating patients with RMPP from those with GMPP. Multiple logistic regression analysis showed that the CRP≥16.5mg-L, LDH ≥417IU-L and IL-6 ≥14.75pg-ml were significant predictors regarding to RMPP.

Conclusions

CRP≥16.5mg-L, LDH ≥417IU-L and IL-6 ≥14.75pg-ml might be the significant predictors of RMPP in children, which can aid in early recognition of RMPP.



Autor: Yuanyuan Zhang, Yunlian Zhou, Shuxian Li, Dehua Yang, Xiling Wu, Zhimin Chen

Fuente: http://plos.srce.hr/



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