[A retrospective cohort study based on propensity score matching evaluated the effect of bronchoalveolar lavage on the clinical prognosis of children with macrolide drug-resistant Mycoplasma pneumoniae pneumonia].
B C Wu, S T Xiang, L H Liu, C Xu, Y N Meng, Y P Chen
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引用次数: 0
Abstract
To evaluate the effect of bronchoalveolar lavage (BAL) on the clinical prognosis of children with macrolide drug-resistant Mycoplasma pneumoniae pneumonia (MRMPP) in a retrospective cohort study based on propensity score matching (PSM).A retrospective cohort study based on propensity score matching retrospectively collected the clinical data of hospitalized patients diagnosed with mycoplasma macrolide drug-resistant pneumonia (MRMPP) in Respiratory Department of Hunan Children's Hospital from January 2020 to August 2023. According to whether bronchoalveolar lavage (BAL) was performed during hospitalization, the children were divided into BAL group and non-BAL group, and the baseline information of the two groups was matched by propensity scores, and the clinical prognosis was compared. A total of 302 children were screened, and 150 cases were successfully matched, including 59 cases in the BAL group and 91 cases in the non-BAL group. The results showed that the differences between the non-BAL group and the BAL group before PSM(P<0.05) were significantly different in age [(4.60±2.97)years vs (5.41±3.02) years, t=-2.273, P=0.024], shortness of breath (9.4% vs 22.5%, χ2=9.864, P=0.002), and radiographic manifestations [lung interstitial changes (29.8% vs 15.3%, χ2=8.009, P=0.005), lung consolidation (17.3% vs 55.9%, χ2=48.457, P<0.001), spotted flaky infiltrates (52.4% vs 27.9%, χ2=17.056, P<0.001)], bacterial infection (3.2% vs 9.2%, χ2=4.845, P=0.028), duration of azithromycin or doxycycline use [4(2, 5) days vs 5(3, 6) days, Z=-2.374, P=0.018], White Blood Cell Count at admission [7.94 (6.25, 10.34)×109/L vs 7.21 (5.65, 9.01)×109/L, Z=-2.445, P=0.014], D Dimer [0.58 (0.44, 0.83) μg/ml vs 0.80 (0.52, 1.12) μg/ml, Z=-3.154, P=0.002], but there was no significant difference between the two groups in the above indexes after PSM (P>0.05). The duration of hospitalization, cough relief, disappearance of rales and fever in the BAL group was shortened in the BAL group compared with that in the non-BAL group [5 (4, 7) days vs 7 (5, 8) days, Z=-2.373, P=0.018], and the difference was statistically significant (P<0.05). Linear regression analysis of PSM cohort study showed that BAL was negatively correlated with fever time (β=-4.369, 95%CI:-8.600--0.138, P<0.05). In conclusion, BAL can shorten the fever time of MRMPP, and early BAL in addition to conventional treatment has a positive effect on the prognosis of children.
在一项基于倾向评分匹配（PSM）的回顾性队列研究中，评估支气管肺泡灌洗（BAL）对耐大环内酯类药物肺炎支原体肺炎（MRMPP）患儿临床预后的影响。一项基于倾向评分匹配的回顾性队列研究收集了湖南省儿童医院呼吸科2020年1月至2023年8月期间确诊为大环内酯类药物耐药支原体肺炎（MRMPP）住院患者的临床资料。根据住院期间是否进行支气管肺泡灌洗（BAL），将患儿分为BAL组和非BAL组，两组基线资料通过倾向评分进行匹配，并比较临床预后。共筛选出302例患儿，150例成功配对，其中BAL组59例，非BAL组91例。结果显示，非BAL组与BAL组在PSM（Pvs（5.41±3.02）岁，t=-2.273，P=0.024]、气短（9.4% vs 22.5%，χ2=9.864，P=0.002）、影像学表现[肺间质改变（29.8% vs 15.3%，χ2=8.009，P=0.005）、肺部合并症（17.3% vs 55.9%，χ2=48.457，Pvs 27.9%，χ2=17.056，Pvs 9.2%，χ2=4.845，P=0.028）、阿奇霉素或强力霉素使用时间[4（2，5）天 vs 5（3，6）天，Z=-2.374，P=0.018]、入院时白细胞计数[7.94（6.25，10.34）×109/L vs 7.21（5.65，9.01）×109/L，Z=-2.445，P=0.014]，D二聚体[0.58（0.44，0.83）μg/ml vs 0.80（0.52，1.12）μg/ml，Z=-3.154，P=0.002]，但PSM后两组患者上述指标无明显差异（P>0.05）。与非 BAL 组相比，BAL 组的住院时间、咳嗽缓解时间、啰音消失时间和发热时间均缩短[5（4，7）天 vs 7（5，8）天，Z=-2.373，P=0.018]，差异有统计学意义（PCI：-8.600--0.138，P
期刊介绍：
Chinese Journal of Preventive Medicine (CJPM), the successor to Chinese Health Journal , was initiated on October 1, 1953. In 1960, it was amalgamated with the Chinese Medical Journal and the Journal of Medical History and Health Care , and thereafter, was renamed as People’s Care . On November 25, 1978, the publication was denominated as Chinese Journal of Preventive Medicine . The contents of CJPM deal with a wide range of disciplines and technologies including epidemiology, environmental health, nutrition and food hygiene, occupational health, hygiene for children and adolescents, radiological health, toxicology, biostatistics, social medicine, pathogenic and epidemiological research in malignant tumor, surveillance and immunization.
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