肺炎支原体肺炎患儿胸部CT影像学特征与肺功能的关系及对预后的预测价值OA

Objective To explore the relationship between chest CT imaging features and pulmonary function in children with Mycoplasma pneumoniae pneumonia(MPP),and to analyze its predictive value for poor prognosis,so as to provide reference for clinical diagnosis and treatment.Methods A total of 120 children with MPP admitted from January 2021 to February 2024 were selected and divided into mild group(n=53)and severe group(n=67)according to the severity of the disease.The chest CT imaging features and pulmonary function indexes[percentage of predicted forced vital capacity(FVC%),percentage of predicted forced expiratory volume in the first second(FEV1%),respiratory rate(RR),tidal volume(VT),time to peak expiratory flow to total expiratory time ratio(TPTEF/TE),volume to peak expiratory flow to total expiratory volume ratio(VPTEF/VE)(VPTEF/VE)]were compared between the two groups,and the relationship between chest CT imaging features and pulmonary function was analyzed.The chest CT imaging features of MPP children with different prognoses were compared,and their predictive value for poor prognosis was analyzed.Results The incidence rates of ground-glass opacities(GGO),reticular opacities,large patchy consolidations and chest CT score in the mild group were lower than those in the severe group(P<0.05).The FVC%and FEV1%,VT,TPTEF/TE,and VPTEF/VE in the mild group were all higher than those in the severe group,while the RR was lower in the mild group than in the severe group(P<0.05).Children with MPP who had GGO,reticular opacities,and large patchy consolidations had lower FVC%,FEV1%,VT,TPTEF/TE,and VPTEF/VE compared with those without GGO,reticular opacities,and large patchy consolidations,while the RR was higher in these children than in those without GGO,reticular opacities,and large patchy consolidations(P<0.05).After one course of treatment,the prognosis was evaluated.Of them,41 patients were included in the poor prognosis group and 79 patients were included in the good prognosis group.The incidence of GGO,reticular opacities,large patchy consolidations and chest CT score in the poor prognosis group were higher than those in the good prognosis group(P<0.05).The receiver operating characteristic(ROC)curve analysis showed that the combination of GGO,reticular opacities,large patchy consolidations and chest CT score had the largest area under the curve for predicting poor prognosis in children with MPP,which was 0.889(95%CI:0.819,0.939),with a sensitivity of 85.37%and a specificity of 77.22%.Conclusion The imaging features of chest CT in children with MPP are closely related to pulmonary function.The combination of GGO,reticular opacities,large patchy consolidations and chest CT score has a high value in predicting the risk of poor prognosis in children.