Clinical study of pediatric severe Mycoplasma pneumoniae pneumonia complicated with pulmonary embolism
10.3760/cma.j.cn101070-20250126-00064
- VernacularTitle:儿童重症肺炎支原体肺炎并发肺栓塞的临床研究
- Author:
Lijun LUO
1
;
Yun CUI
;
Mingjun ZHANG
;
Yucai ZHANG
;
Yiping ZHOU
;
Fei SUN
;
Chenggao XU
;
Shunfeng MAO
;
Ting SUN
;
Yijun SHAN
;
Ye LU
Author Information
1. 嘉兴市第一医院，嘉兴大学附属医院儿科，嘉兴 314000
- Publication Type:Journal Article
- Keywords:
Mycoplasma pneumoniae pneumonia;
Pulmonary embolism;
Risk factor;
D-dimer
- From:
Chinese Journal of Applied Clinical Pediatrics
2025;40(10):775-779
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical features and risk factors for pediatric severe Mycoplasma pneumoniae pneumonia (SMPP) complicated with pulmonary embolism. Methods:SMPP patients admitted to Department of Pediatrics, Jiaxing First Hospital and Pediatric Intensive Care Unit, Shanghai Children′s Hospital from December 2019 to December 2023 were included in this retrospective case-control study.According to whether they were complicated with pulmonary embolism, SMPP patients were divided into a pulmonary embolism group and a non-pulmonary embolism group.Clinical characteristics of the two groups, including general data, laboratory examination and imaging data were compared and analyzed.The t-test and Mann-Whitney rank-sum test were used to compare the measurement data, and the χ2 test was used to compare the count data.The risk factors of SMPP patients developing pulmonary embolism were analyzed by the univariate method. Results:There were 10 out of 62 SMPP children developing pulmonary embolism, showing an incidence of 16.13%.In the pulmonary embolism group, there were 5 boys and 5 girls, with a median age of 7.50 (5.75, 9.25) years.There were 52 children in the non-pulmonary embolism group, including 29 boys and 23 girls, with a median age of 6.50(5.00, 8.00)years.The hospitalization time, body temperature, total white blood cell count, neutrophil count, C-reactive protein levels, lactate dehydrogenase levels, prothrombin time, activated partial thromboplastin time, D-dimer (D-D) levels, fibrinogen degradation product levels, pleural effusion and atelectasis rates in the pulmonary embolism group were significantly higher than those in the non-pulmonary embolism group (all P<0.05). Fibrinogen levels in the pulmonary embolism group were significantly lower than those in the non-pulmonary embolism group ( P<0.05). Univariate Logistic regression analysis showed that the D-D level was a risk factor for SMPP patient developing pulmonary embolism.The receiver operating characteristic curve analysis revealed that the D-D level had the largest area under the curve for predicting pulmonary embolism of 0.990(95% CI: 0.972-1.000, P<0.001), with a sensitivity of 100%, a specificity of 92%, and a cut-off value of 4.63 mg/L. Conclusions:SMPP children complicated with pulmonary embolism are prone to high inflammation and impaired coagulation function.The increase of D-D levels is a risk factor for the development of pulmonary embolism in SMPP.
