Abstract：
OBJECTIVE: Pulmonary embolism (PE) is not a rare complication of Mycoplasma pneumoniae pneumonia (MPP) in children. We sought to determine the incidence of PE in children with MPP who underwent clinically indicated CT pulmonary angiography (CTPA) and to evaluate the risk factors for PE.
METHODS: All 106 children with MPP who were clinically suspected of having PE and who underwent CTPA were retrospectively enrolled from June 2018 to December 2021. The clinical features, laboratory data, and radiological parameters were recorded (e.g., lung consolidation involved and the Qanadli score). A Cox proportional hazards model and area under the receiver operating characteristic (ROC) curve were used to evaluate the risk factors and prognostic discriminatory capacity for PE.
RESULTS: PE was detected in 26 of 106 (24.5 %) children (mean age, 6.2 years ± 3.3 years; 53 boys). Sixteen of the 26 (61.5 %) children with PE were boys. The mean age of the children with PE was 8.1 ± 2.9 years, and the mean Qanadli score was 15.3 ± 10.2. Children with PE had higher D-dimer levels (9.3 ± 7.1 mg/Lvs. 3.6 ± 3.8 mg/L) and a greater frequency of lung lobe consolidation (25 (96.2 %) vs. 64 (80.0 %)) (all P < 0.05). For children with MPP, age (hazard ratio (HR) = 1.96 (95 % CI1.04, 3.71; P = 0.037), D-dimer level (HR = 1.52, 95 % CI: 1.03, 2.24; P = 0.029), and bilateral lung consolidation (HR = 2.41, 95 % CI: 1.03, 5.58; P = 0.043) were found to be independent predictors of PE.
CONCLUSIONS: Clinical and CT radiological predictors could be used to predict PE in children with MPP. The use of risk factor assessment as a tool has the potential to guide more appropriate use of CTPA in children.
METHODS: All 106 children with MPP who were clinically suspected of having PE and who underwent CTPA were retrospectively enrolled from June 2018 to December 2021. The clinical features, laboratory data, and radiological parameters were recorded (e.g., lung consolidation involved and the Qanadli score). A Cox proportional hazards model and area under the receiver operating characteristic (ROC) curve were used to evaluate the risk factors and prognostic discriminatory capacity for PE.
RESULTS: PE was detected in 26 of 106 (24.5 %) children (mean age, 6.2 years ± 3.3 years; 53 boys). Sixteen of the 26 (61.5 %) children with PE were boys. The mean age of the children with PE was 8.1 ± 2.9 years, and the mean Qanadli score was 15.3 ± 10.2. Children with PE had higher D-dimer levels (9.3 ± 7.1 mg/Lvs. 3.6 ± 3.8 mg/L) and a greater frequency of lung lobe consolidation (25 (96.2 %) vs. 64 (80.0 %)) (all P < 0.05). For children with MPP, age (hazard ratio (HR) = 1.96 (95 % CI1.04, 3.71; P = 0.037), D-dimer level (HR = 1.52, 95 % CI: 1.03, 2.24; P = 0.029), and bilateral lung consolidation (HR = 2.41, 95 % CI: 1.03, 5.58; P = 0.043) were found to be independent predictors of PE.
CONCLUSIONS: Clinical and CT radiological predictors could be used to predict PE in children with MPP. The use of risk factor assessment as a tool has the potential to guide more appropriate use of CTPA in children.
摘要：
目的：肺栓塞（PE）不是儿童肺炎支原体肺炎（MPP）的罕见并发症。我们试图确定接受临床指示的CT肺动脉造影（CTPA）的MPP患儿的PE发生率，并评估PE的危险因素。
方法：2018年6月至2021年12月，回顾性纳入临床怀疑患有PE并接受CTPA的所有106例MPP患儿。临床特征，实验室数据,并记录放射学参数(例如，涉及肺巩固和Qanadli评分）。使用Cox比例风险模型和受试者工作特征（ROC）曲线下面积评估PE的危险因素和预后判别能力。
结果：在106名儿童中的26名（24.5％）中检测到PE（平均年龄，6.2岁±3.3岁；53个男孩）。26名患有PE的儿童中有16名（61.5％）是男孩。PE患儿的平均年龄为8.1±2.9岁,平均Qanadli评分为15.3±10.2。PE患儿的D-二聚体水平较高（9.3±7.1mg/Lvs。3.6±3.8mg/L）和更大的肺叶实变频率（25（96.2%）与64(80.0%))(均P<0.05)。对于患有MPP的儿童，年龄（危险比（HR）=1.96（95%CI1.04，3.71；P=0.037），D-二聚体水平(HR=1.52,95%CI:1.03,2.24;P=0.029),和双侧肺实变(HR=2.41,95%CI:1.03,5.58;P=0.043)是PE的独立预测因子。
结论：临床和CT影像学预测因子可用于预测MPP患儿的PE。使用危险因素评估作为工具有可能指导儿童更适当地使用CTPA。
方法：2018年6月至2021年12月，回顾性纳入临床怀疑患有PE并接受CTPA的所有106例MPP患儿。临床特征，实验室数据,并记录放射学参数(例如，涉及肺巩固和Qanadli评分）。使用Cox比例风险模型和受试者工作特征（ROC）曲线下面积评估PE的危险因素和预后判别能力。
结果：在106名儿童中的26名（24.5％）中检测到PE（平均年龄，6.2岁±3.3岁；53个男孩）。26名患有PE的儿童中有16名（61.5％）是男孩。PE患儿的平均年龄为8.1±2.9岁,平均Qanadli评分为15.3±10.2。PE患儿的D-二聚体水平较高（9.3±7.1mg/Lvs。3.6±3.8mg/L）和更大的肺叶实变频率（25（96.2%）与64(80.0%))(均P<0.05)。对于患有MPP的儿童，年龄（危险比（HR）=1.96（95%CI1.04，3.71；P=0.037），D-二聚体水平(HR=1.52,95%CI:1.03,2.24;P=0.029),和双侧肺实变(HR=2.41,95%CI:1.03,5.58;P=0.043)是PE的独立预测因子。
结论：临床和CT影像学预测因子可用于预测MPP患儿的PE。使用危险因素评估作为工具有可能指导儿童更适当地使用CTPA。
