肺炎支原体肺炎患儿胸部X线片及CT双模态影像学分型与其临床特征及预后的关系OA
Relationship between the dual-modal imaging classification of chest X-ray and CT in chil-dren with mycoplasma pneumoniae and their clinical features and prognosis
目的 探究肺炎支原体肺炎(MPP)患儿胸部 X 线片及 CT 双模态影像学分型与其临床特征及预后的关系.方法 回顾性分析 2023-01-01 至 2024-12-31 武警特色医学中心收治的 MPP 患儿,按 X 线表现分为支气管肺炎型和实变/肺不张型,按 CT 表现分为支气管肺炎型、实变/肺不张型和细支气管炎型.比较不同影像学分类患儿的临床特征、炎症指标及预后(难治性 MPP、坏死性肺炎、闭塞性细支气管炎等)差异.结果 共纳入 143 例患儿,X 线分型支气管肺炎型 84 例、实变/肺不张型 59 例.CT 分型实变/肺不张型 104 例、支气管肺炎型 22 例、细支气管炎型 17 例.在 X 线影像分类中,与支气管肺炎型相比,实变/肺不张型患儿年龄更大,C 反应蛋白、中性粒细胞/淋巴细胞比值、乳酸脱氢酶及 D-二聚体水平更高(均 P<0.05),难治性 MPP 发生率、坏死性肺炎发生率及 ICU 入住率更高,住院时间更长.CT 细支气管炎型患儿过敏性疾病史(29.41%)及湿啰音发生率(88.24%)为三组最高,差异有统计学意义(均 P<0.05),且为闭塞性细支气管炎的潜在高危类型.结论 MPP 的 X 线片及 CT 影像学分型与临床特征及预后密切相关.X 线片可作为初筛工具初步预测病情严重程度,CT 能更精准识别细支气管炎等细微病变,为早期干预及远期并发症预警提供更可靠依据.
Objective To investigate the relationship between the dual-modal imaging classification of chest X-ray and CT in children with mycoplasma pneumoniae(MPP)and their clinical features and prognosis.Methods A retrospective analysis was per-formed on 143 children with MPP who were admitted to Characteristics Medical Center of Chinese People's Armed Police Force from January 1,2023 to December 31,2024.According to X-ray findings,the children were divided into bronchopneumonia type and con-solidation/atelectasis type.Based on CT findings,they were classified into bronchopneumonia type,consolidation/atelectasis type,and bronchiolitis type.Clinical features,inflammatory indicators,and prognosis(including refractory MPP,necrotizing pneumonia,obli-terative bronchiolitis,etc.)were compared among children with different imaging classifications.Results Among the 143 children,X-ray classification revealed 84 cases of bronchopneumonia type and 59 cases of consolidation/atelectasis type.CT classification identi-fied 104 cases of consolidation/atelectasis type,22 cases of bronchopneumonia type,and 17 cases of bronchiolitis type.In the X-ray imaging classification,compared with the bronchopneumonia type,children with consolidation/atelectasis type were older,had signifi-cantly higher levels of C-reactive protein,neutrophil-to-lymphocyte ratio,lactate dehydrogenase,and D-dimer(all P<0.05),as well as higher incidence of refractory MPP,necrotizing pneumonia,and ICU admission,and longer hospital stay.Children with CT-defined bronchiolitis type had the highest prevalence of allergic disease history(29.41%)and rales(88.24%)among the three groups(all P<0.05),and this type was identified as a potential high-risk factor for obliterative bronchiolitis.Conclusions X-ray and CT imaging classifications of MPP are closely related to clinical features and prognosis.X-ray can serve as an initial screening tool to preliminarily predict disease severity,while CT can more accurately identify subtle lesions such as bronchiolitis,providing a more reliable basis for early intervention and early warning of long-term complications.
王潇健;贾兆刚;王剑;卢明明;歹丽红;张晶晶
300162 天津,武警特色医学中心儿科300162 天津,武警特色医学中心医学影像科300162 天津,武警特色医学中心儿科300162 天津,武警特色医学中心医学影像科300162 天津,武警特色医学中心儿科300162 天津,武警特色医学中心儿科
医药卫生
肺炎支原体儿童胸部影像分类临床结局
mycoplasma pneumoniaechildrenchest ima-gingclassificationclinical outcome
《武警医学》 2026 (7)
563-568,574,7
天津市卫生健康科技项目(TYWJ2021MS043)
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