2021 年第 5 期 第 16 卷

肺脏超声检查对儿童重症肺炎支原体肺炎的预测价值分析

Predictive value of lung ultrasound in children with severe mycoplasma pneumoniae pneumonia

作者：董晓培秦选光

英文作者：Dong Xiaopei Qin Xuanguang

单位：首都医科大学附属北京朝阳医院儿科100020

英文单位：Department of Pediatrics Beijing Chaoyang Hospital Capital Medical University Beijing 100020 China

关键词：肺炎支原体肺炎；肺脏超声；儿童

英文关键词：Mycoplasmapneumoniaepneumonia；Lungultrasound；Children

• 摘要：

• 目的 分析肺脏超声检查对儿童重症肺炎支原体肺炎(SMPP)的预测价值。方法 选择2017年1月至2018年12月首都医科大学附属北京朝阳医院儿科病房住院的141例肺炎支原体肺炎患儿为研究对象，根据病情分为普通MPP（CMPP）组（107例）和SMPP组（34例）。比较2组患儿一般资料及肺脏超声检查结果，分析肺脏超声检查对SMPP的预测价值。结果 SMPP组入院前发热时间、住院时间、肺脏超声检查示肺炎实变长径＞4.2 cm比例、实变面积及实变长径均显著长于/大于CMPP组［7（6,9）d比6（4,7）d、8（6,9）d 比6（5,7）d、79.4%（27/34）比41.9%（39/93）、27.21(12.74,53.31)cm2比4.94(1.10,15.20)cm2、（7.0±2.7）cm比（3.6±2.5）cm］（均P＜0.05）。受试者工作特征曲线分析结果显示，以肺炎实变面积10.995 cm2为界值时，预测SMPP的敏感度和特异度分别为82.4%和69.2%；以肺炎实变长径5.75 cm为界值时，预测SMPP的敏感度和特异度分别为67.6%和 79.4%。结论 肺脏超声检查可作为辅助诊断儿童SMPP的手段之一，以减少或避免射线暴露。

• Objective To analyze the predictive value of lung ultrasound in children with severe mycoplasma pneumoniae pneumonia (SMPP). Methods From January 2017 to December 2018, 141 children with mycoplasma pneumoniae pneumonia who were admitted to the pediatric ward of Beijing Chaoyang Hospital, Capital Medical University were selected. The children were divided into common MPP(CMPP) group (107 cases) and SMPP group (34 cases) according to their illness. The general information and the characteristics of lung ultrasound images were compared between the two groups, and the predictive value of lung ultrasound indexes for SMPP was analyzed. Results The fever time before admission, hospitalization time, the proportion of pneumonia consolidation length diameter＞4.2 cm, consolidation area and consolidation length diameter of SMPP group were higher than those of CMPP group［7（6,9）d vs 6（4,7）d, 8（6,9）d vs 6（5,7）d, 79.4%（27/34） vs 41.9%（39/93）, 27.21(12.74,53.31)cm2 vs 4.94(1.10,15.20)cm2, （7.0±2.7）cm vs （3.6±2.5）cm］(all P＜0.05). The receiver operating characteristic curve analysis found that when the pneumonia consolidation area was 10.995 cm2 as the boundary value, the sensitivity and specificity of predicting SMPP was 82.4% and 69.2% respectively; when the pneumonia consolidation length diameter was 5.75 cm as the boundary value, the sensitivity and specificity of predicting SMPP was 67.6% and 79.4% respectively. Conclusion Lung ultrasound can be used as one of the methods to assist in the diagnosis of SMPP in children to reduce or avoid radiation exposure.