【摘要】 目的 分析儿童支原体肺炎重症肺炎的影响因素。方法 选择2021年3月～2022年2月山西省儿童医院收治的支原体肺炎307例患儿为研究对象，分为重症组(200例)及非重症组(107例),比较两组患儿临床资料的差异，建立列线图预测模型，对模型进行内部验证。结果 重症组≥3岁且<6岁、≥6岁且≤10岁以及秋、冬季患病人数较多(P<0.05)。两组患儿的临床表现包括病程、峰值体温、心电图异常表现、三凹征阳性、口周发绀、肺外表现、累及其他系统方面，差异均有统计学意义(P均<0.05);两组患儿的实验室检测指标，包括EB病毒感染、抗体效价水平及C反应蛋白等15项指标方面，差异均有统计学意义(P均<0.05)。Logistic回归分析结果显示，病程长以及血小板计数、乳酸脱氢酶、Th细胞水平升高与重症肺炎的发生呈正相关，NK细胞水平升高与重症肺炎的发生呈负相关(P<0.05)。列线图结果显示，发生重症肺炎的概率为92.8%,校正曲线与理想曲线基本一致，受试者工作特征曲线下面积为0.819。决策曲线显示，阈值概率在4%～89%时具有较高的净获益值。结论 列线图模型有助于早期发现儿童支原体肺炎重症肺炎的患者，对预防发展为重症肺炎提供支持。更多还原

【Abstract】 Objective To analyze the influencing factors of severe pneumonia in children with mycoplasma pneumonia. MethodsA total of 307 children with mycoplasma pneumonia hospitalized in Shanxi Children′s Hospital from March 2021 to February 2022 were selected as the study subjects and divided into severe group(200 cases) and non-severe group(107 cases). The differences of the clinical data between the two groups were compared, and a nomogram prediction model was established, and the model was internally validated. Results The severe group had more patients aged ≤3 and <6 years, ≥6 and ≤10 years and autumn and winter(P<0.05). There were significant differences in the course of disease, peak body temperature, abnormal electrocardiogram findings, three concave signs positive, perioral cyanosis, extrapulmonary manifestations, and involvement of other systems between the two groups(P<0.05). There were significant differences between the two groups in 15 indicators including epstein-barr virus infection, antibody titer levels, and C-reactive protein among the laboratory test indicators(P<0.05). The Logistic regression analysis showed that long disease duration and elevated platelet count, lactate dehydrogenase, and Th cell levels were positively correlated with the occurrence of severe pneumonia, and elevated NK cell levels were negatively correlated with the occurrence of severe pneumonia(P<0.05). The nomogram results showed that the probability of severe pneumonia was 92.8%, the calibration curve was basically consistent with the ideal curve, the area under the receiver operating characteristic curve was 0.819, and the decision curve showed a high net benefit value when the threshold probability was 4%-89%. Conclusion The nomogram model is helpful for early detection of severe pneumonia in children with mycoplasma pneumonia, and has important significance for preventing the development of severe pneumonia.更多还原