儿童肺炎支原体肺炎临床特征分析

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目的了解小儿肺炎支原体肺炎(MPP)临床特征,以期提高临床诊治小儿MPP的水平。方法以我院2008年1月~2012年12月期间93例确诊为MPP住院儿童患者为研究对象,回顾性总结和分析患者的临床症状、体征、胸部影像学和相关实验室指标等情况。结果在本组93例血清抗肺炎支原体抗体(抗MP-IgM)阳性的患儿中,以学龄儿童最为常见(≥6岁,占53.8%);尽管早期无明显阳性体征,但93.4%患儿可表现为持续发热伴刺激性咳嗽。在本组患儿中,共有91.4%(85/93)进行了痰培养,但仅5.9%(5/85)痰培养阳性;73.1%(68/93)患儿外周血白细胞总数和(或)中性粒细胞百分比正常,但分别有80.6%(75/93)和59.1%(55/93)的患儿检测到血沉和C反应蛋白的增高;88.2%(82/93)的患儿胸片提示一侧大片絮状阴影且以右侧(56/82,68.3%)常见,而仅5.4%(5/93)患儿表现为双侧大片絮状阴影;共有29.0%(27/93)患儿出现肺外合并症,尤以渗出性胸膜炎(55.6%,15/27)最为常见。结论小儿MP好发于学龄儿童,痰培养阳性率低,血清抗MP抗体筛查和患儿临床特征分析有助于早期诊断MP。 Objective To understand the clinical features of children with Mycoplasma pneumoniae pneumonia (MPP) in order to improve the clinical diagnosis and treatment of children with MPP levels. Methods From January 2008 to December 2012 in our hospital 93 cases were diagnosed as MPP hospitalized children as the research object, and retrospectively summarizes and analyzes the patient’s clinical symptoms, signs, chest imaging and related laboratory indicators. Results Among the 93 children with positive anti-Mycoplasma pneumoniae antibody (anti-MP-IgM) in this group, the most common were children of school age (≥6 years, accounting for 53.8%). Although there were no obvious positive signs in early stage, 93.4% of children Can be manifested as persistent fever with irritating cough. In this group of children, a total of 91.4% (85/93) of sputum culture, but only 5.9% (5/85) sputum culture positive; 73.1% (68/93) of children with peripheral blood leukocytes and (or) The percentage of neutrophils was normal, but the erythrocyte sedimentation rate and C-reactive protein were detected in 80.6% (75/93) and 59.1% (55/93) children respectively. 88.2% (82/93) A large flocculent shadow on one side was common and was common on the right side (56/82, 68.3%), while only 5.4% (5/93) showed massive flocculent shadows on both sides; a total of 29.0% (27/93) Children with extrapulmonary complications, especially exudative pleurisy (55.6%, 15/27) the most common. Conclusion The incidence of MP in children is higher than that in school-age children, and the positive rate of sputum culture is low. Serum anti-MP antibody screening and analysis of clinical features of children may be helpful for the early diagnosis of MP.
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