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目的了解混合感染因素对难治性肺炎支原体肺炎(RMPP)的作用及影响。方法收集并分析2013年1月至2015年12月286例RMPP患儿的病史资料。依据病原检测结果将患儿分为RMPP混合感染组和单纯感染组,比较两组患儿临床特征及实验室检查结果。结果混合感染组患儿热程和住院天数分别为12.5(11.0~14.0)d、12.00(9.0~14.0)d,均明显高于单纯感染组的11.0(9.0~13.0)d、10.0(8.0~12.0)d,差异均有统计学意义(P均<0.01)。混合感染组患儿白细胞计数,中性粒细胞百分比,血小板计数,乳酸脱氢酶、C反应蛋白(CRP)>40 mg/L、CRP>100 mg/L及CK-MB升高发生率均高于单纯感染组,差异有统计学意义(P均<0.05)。混合感染组气胸、呼吸衰竭发生率高于单纯感染组,差异均有统计学意义(P均<0.05)。混合感染组血液系统损害、心肌损害、电解质紊乱发生率高于单纯感染组,差异均有统计学意义(P均<0.05)。结论混合感染会使RMPP患儿发热时间延长,全身炎症反应加重,肺内外并发症发生率升高,并增加患儿的住院时间。
Objective To investigate the effect of mixed infection on refractory Mycoplasma pneumoniae pneumonia (RMPP). Methods A total of 286 cases of RMPP in our hospital from January 2013 to December 2015 were collected and analyzed. According to the pathogen test results, the children were divided into RMPP mixed infection group and simple infection group. The clinical characteristics and laboratory test results of two groups were compared. Results The days of fever and hospital stay in the mixed infection group were 12.5 (11.0-14.0) d and 12.00 (9.0-14.0) d, respectively, which were significantly higher than those in the simple infection group (11.0 9.0-10.0 d, 10.0 8.0-12.0 ) d, the differences were statistically significant (P all <0.01). The incidences of white blood cell count, neutrophil percentage, platelet count, lactate dehydrogenase, C-reactive protein (CRP)> 40 mg / L, CRP> 100 mg / L and CK- In simple infection group, the difference was statistically significant (P <0.05). The incidence of pneumothorax and respiratory failure in mixed infection group was higher than that in simple infection group (all P <0.05). The incidences of blood system damage, myocardial damage and electrolyte disturbance in mixed infection group were higher than those in simple infection group (all P <0.05). Conclusions Mixed infection prolongs fever, prolong systemic inflammatory response, increase the incidence of pulmonary complications and increase hospitalization time in children with RMPP.