| 摘要: |
| 目的:根据淋巴细胞计数/ C 反应蛋白值(LCR)建立预测重症肺炎支原体肺炎(MPP)患儿气道损伤和预后的模型,并探 讨治疗方案。 方法:选择我院 2023 年 12 月-2024 年 12 月收治的 170 例 MPP 患儿,分为轻症组 102 例和重症组 68 例,并根据 6 个月随访情况分为预后良好组 122 例和预后不良组 48 例。 分层回归、受试者工作特征(ROC)曲线、logistic 回归、限制性立方 样条(RCS)分析用于相关及预测价值评估。 结果:重症组患儿纤维支气管镜下各类气道异常(纵行皱褶、分泌物增多、气道黏液 栓堵塞、叶或段支气管开口炎性狭窄、管腔软化、闭塞、肉芽组织增生及黏膜糜烂)的发生率均高于轻症组(P<0. 05),分层回归 分析显示上述气道异常表现均与 LCR 呈负相关(P<0. 05);ROC 曲线分析显示,LCR 预测轻症 MPP 进展为重症 MPP 的 AUC 为 0. 92(95%CI 0. 82~0. 97)。 此外,LCR 水平与预后不良独立相关。 同时 LCR 水平在不同病情严重程度患儿中均与预后不良呈 非线性负相关,当 LCR<0. 16 时预后不良风险明显上升。 结论:LCR 与 MPP 患儿气道损伤及预后密切相关,基于其构建的预测 模型可有效识别高危患儿,并指导早期分层治疗决策,具有重要的临床转化价值。 |
| 关键词: 肺炎支原体肺炎 儿童 淋巴细胞计数/ C 反应蛋白值 气道损伤 转归模型 治疗策略 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2026.09.007 |
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| 基金项目:安徽省妇幼保健协会“母婴营养与健康研究项目”,编号 AHFY202201。 |
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| Establishment of Prediction Model for Airway Injury and Prognosis and Development of Therapeutic Strategies Based on Lymphocyte-C-Reactive Protein Ratio in Children with Mycoplasma Pneumoniae Pneumonia |
| Zhou Yan, Yu Xiao, Li Dan, Zhu Zhankui |
| (Fuyang Women and Children’s Hospital, Anhui Fuyang 236031, China) |
| Abstract: |
| Objective: To establish the model for predicting airway injury and prognosis in children with severe Mycoplasma pneumoniae pneumonia (MPP) based on lymphocyte-C-reactive protein ratio (LCR), and to explore the treatment regimen. Methods: Totally 170 children with MPP admitted into our hospital from Dec. 2023 to Dec. 2024 were extracted to be divided into the mild group (102 cases) and severe group (68 cases). The 6-month follow-up results were used to classify the children into the good prognosis group (122 cases) and poor prognosis group (48 cases). Hierarchical regression, receiver operator characteristic (ROC) curve, logistic regression, and restricted cubic spline (RCS) analysis were used to evaluate the correlation and predictive value. Results: The severe group exhibited higher incidences of airway abnormalities ( longitudinal folds, increased secretions, mucus plug obstruction, inflammatory stenosis, lumen softening, obstruction, granulation hyperplasia, and mucosal erosion) than mild group ( P < 0. 05). Hierarchical regression analysis revealed these abnormalities were negatively correlated with LCR (P< 0. 05). ROC curve analysis showed an AUC of 0. 92 (95% CI 0. 82 to 0. 97) for LCR in predicting progression from mild to severe MPP. Additionally, LCR levels were independently and non-linearly associated with poor prognosis, with a significantly increased risk when LCR <0. 16. Conclusion: LCR is closely related to airway injury and prognosis in children with MPP. The predictive model can effectively identify high-risk children and guide early stratified treatment decisions, and has important clinical application value. |
| Key words: Mycoplasma pneumoniae pneumonia children lymphocyte-C-reactive protein ratio airway injury prognosis model treatment strategy |
