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86例儿童塑型性支气管炎临床分析

舒玲莉 钟琳 丘力 李艳 张瑞 刘瀚旻

舒玲莉, 钟琳, 丘力, 等. 86例儿童塑型性支气管炎临床分析[J]. 四川大学学报(医学版), 2021, 52(5): 855-858. doi: 10.12182/20210960509
引用本文: 舒玲莉, 钟琳, 丘力, 等. 86例儿童塑型性支气管炎临床分析[J]. 四川大学学报(医学版), 2021, 52(5): 855-858. doi: 10.12182/20210960509
SHU Ling-li, ZHONG Lin, QIU Li, et al. Clinical Analysis of 86 Cases of Children with Plastic Bronchitis[J]. JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION), 2021, 52(5): 855-858. doi: 10.12182/20210960509
Citation: SHU Ling-li, ZHONG Lin, QIU Li, et al. Clinical Analysis of 86 Cases of Children with Plastic Bronchitis[J]. JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION), 2021, 52(5): 855-858. doi: 10.12182/20210960509

86例儿童塑型性支气管炎临床分析

doi: 10.12182/20210960509
基金项目: 四川省科技计划重点研发项目(No. 2019YFS0037)资助
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    通讯作者:

    E-mail:liuhm@scu.edu.cn

Clinical Analysis of 86 Cases of Children with Plastic Bronchitis

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  • 摘要:   目的  探讨塑型性支气管炎(plastic bronchitis, PB)患儿的临床特征及PB患儿中需要呼吸支持的危险因素,提高对PB的识别能力。  方法  收集2014年3月–2019年12月在我院确诊为PB的患儿资料并分析其临床特征,根据是否接受呼吸支持分为呼吸支持(respiratory support, RS)组和非呼吸支持(no respiratory support, NRS)组,采用logistic回归分析儿童PB需要呼吸支持的危险因素。  结果  本研究共纳入86例PB患儿,其中3岁以上儿童62例(72.1%);57例(66.3%)患儿有并发症;56例患儿入院后予呼吸支持;86例患儿均有发热、咳嗽,76例(88.4%)体温峰值≥39.5°C;82例(95.3%)存在肺大片实变或不张,63例(73.3%)存在胸腔积液;70例(81.4%)检测出病原体,肺炎支原体感染的阳性率最高(68.6%)。NRS组30例(34.9%),RS组56例(65.1%)。logistic回归分析显示,患儿年龄小于3岁(OR=4.99)、有并发症(OR=7.22)为本组PB患儿需要呼吸支持的独立危险因素(P均<0.05)。  结论  临床症状重、合并其他系统并发症、有肺大片实变或不张、胸腔积液以及肺炎支原体阳性时需警惕PB可能。年龄小、合并并发症为PB患儿需要呼吸支持的独立危险因素。
  • 表  1  两组PB患儿临床资料

    Table  1.   Clinical data of the two groups of PB children

    Clinical dataRespiratory supportχ2/ZP
    Not used
    (n=30)
    Use
    (n=56)
    Sex/case (%) 2.381 0.123
     Male 13 (27.7) 34 (72.3)
     Female 17 (43.6) 22 (56.4)
    Age/case (%) 4.864 0.027
     >3 yr. 4 (16.7) 20 (83.3)
     ≥3 yr. 26 (41.9) 36 (58.1)
    Complications/case (%) 12 (21.1) 45 (78.9) 14.236 0.000
    Disease duration before admission/d, M (P25, P75) 11
    (7.5, 15.0)
    10
    (7.0, 15.0)
    −0.354
    0.723
    Length of hospitalization/d, M (P25, P75) 11
    (10.0, 13.5)
    17
    (13.0, 20.5)
    −4.797
    0.000
    Glucocorticoid use/case
     (%)
    13 (22.4)
    45 (77.6)
    12.195
    0.000
    Anhelation/case (%) 6 (15.4) 33 (84.6) 11.945 0.001
    Dyspnea/case (%) 0 (0.0) 27 (100.0) 21.084 0.000
    WBC/case (%) 8.051 0.018
     (4−10)×109 L−1 20 (48.8) 21 (51.2)
     <4×109 L−1 1 (8.3) 11 (91.7)
     >10×109 L−1 9 (27.3) 24 (72.7)
    NEUT/case (%) 4.725 0.030
     ≥1.5×109 L−1 30 (38.5) 48 (61.5)
     <1.5×109 L−1 0 (0.0) 8 (100.0)
    PLT/case (%) 5.782 0.056
     (100−300)×109 L−1 11 (52.4) 10 (47.6)
     <100×109 L−1 0 (0.0) 5 (100.0)
     >300×109 L−1 19 (31.7) 41 (68.3)
    CRP/(mg/L), M (P25, P75)
    44
    (32.3, 75.9)
    58
    (22.3, 116.9)
    −0.617
    0.537
    CRP/case (%) 2.542 0.111
     ≤80 mg/L 26 (39.4) 40 (60.6)
     >80 mg/L 4 (20.0) 16 (80.0)
    LDH/(U/L), M (P25, P75)
    585
    (429.0, 1169.0)
    1262
    (624.0, 1748.5)
    −2.936
    0.030
    下载: 导出CSV

    表  2  是否使用呼吸支持影响因素二元logistic回归结果表

    Table  2.   Binary logistic regression results of factors affecting the use of respiratory support

    FactorsBSEWaldPOR95%CI
    Age (<3 yr.) 1.607 0.741 4.702 0.030 4.990 1.167-21.336
    Complications (yes) 1.977 0.615 10.317 0.001 7.220 2.161-24.124
    LDH 0.001 0.001 3.316 0.069 1.001 1.000-1.002
    WBC (<4×109 L−1)* 2.113 1.254 2.841 0.092 8.276 0.709-96.606
    WBC (>10×109 L−1)* 1.065 0.641 0.190 2.901 0.825-10.198
     * Take WBC (4-10)×109 L−1 as a reference;B: Partial regression coefficient; CI: Confidence interval; OR: Odds ratio; SE: Standard error.
    下载: 导出CSV
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出版历程
  • 收稿日期:  2021-05-09
  • 修回日期:  2021-08-12
  • 网络出版日期:  2021-09-24
  • 刊出日期:  2021-09-20

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