Objective To investigate the possible risk factors for prognosis of diffuse alveolar hemorrhage (DAH) in children and to improve the recognition of the disease.Methods The study included 62 DAH pediatric patients hospitalized from January, 2006 to January, 2016. Clinical data were retrospectively analyzed. According to the basic diseases, children were divided into immune associated DAH and non-immune associated DAH to explore the effect of early glucocorticoid treatment on the two groups of DAH. Based on the prognosis, the patients were divided into the death group and the survival group to analyze its related risk factors.Results Of the 62 patients, 20 were of immune associated DAH, 42 of non-immune associated DAH. There was no signiflcant difference of early treatment with glucocorticoid between the two groups (P>0.05). In our cohort, 30 patients died, the total mortality was 48.4% (30/62). Pediatric critical illness score may be the independent risk factor for DAH mortality.Conclusions DAH is an acute, life-threatening event, the lower the pediatric critical illness score, the higher risk of death.%目的 探讨影响儿童弥漫性肺泡出血(DAH)预后的危险因素.方法 回顾分析2006年1月至2016年1月收治的62例弥漫性肺泡出血患儿的临床资料.根据患儿基础疾病分为免疫性DAH及非免疫性DAH,探讨早期糖皮质激素治疗对两组DAH疗效的影响;根据患儿预后分为死亡组与生存组,分析影响DAH死亡的危险因素.结果 62例DAH患儿中,免疫性DAH 20例、非免疫性DAH 42例,共死亡30例,病死率48.4%.30例早期使用糖皮质激素的DAH患儿中,免疫性DAH 18例,病死率33.3%(6/18例);非免疫性DAH 12例,病死率41.7%(5/12例),两组病死率差异无统计学意义(P=0.712).42例非免疫性DAH患儿中,使用糖皮质激素者病死率41.7%(5/12例),未使用糖皮质激素者病死率60.0%(18/30例),两组病死率差异无统计学意义(P=0.281).Logistic多因素回归分析发现,小儿危重症评分是DAH死亡的独立危险因素(OR=1.15,95%CI:1.03~1.28),为弱相关.结论 DAH是危及儿童生命的临床急重症,小儿危重症评分越低,死亡危险性越高.
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