儿童难治性肺炎支原体肺炎的相关指标

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目的了解儿童难治性肺炎支原体肺炎(RMPP)相关指标,提高对RMPP的认识及早期诊治。方法筛选100例入院前病程<10 d并行支气管镜住院治疗的不同程度肺实变MPP患儿进行分析,根据现行相对严格的定义,分为RMPP组与普通MPP组,对比2组患儿的临床资料及相关常用实验室检查指标。结果 (1)临床资料:100例患儿均有发热、咳嗽症状,RMPP 33例,其中男23例,女10例,应用糖皮质激素26例(78.8%);整叶以上均一致密实变影22例(66.7%);MPP 67例,其中男35例,女32例,应用糖皮质激素41例(61.2%);整叶以上均一致密实变影20例(29.9%)。应有糖皮质激素48 h后体温降至正常RMPP组9例,MPP组30例,MPP组激素有效率明显增高(P<0.05);2组患儿在性别、年龄,开始使用阿奇霉素时间及首次行支气管镜时间等方面差异均无统计学意义(P>0.05)。(2)实验室指标:肺泡灌洗液菌量、黏液栓形成及通气不良在2组患儿比较差异有统计学意义,RMPP组患儿C-反应蛋白(CRP)及乳酸脱氢酶(LDH)均较MPP组患儿增高,差异有统计学意义(P<0.05)。结论整叶以上均一致密实变影、高菌量、支气管镜下黏液栓形成及通气不良,CRP及LDH增高,对小剂量糖皮质激素治疗的反应性均是RMPP的相关指标,应引起儿科医师的重视。 Objective To understand the related indicators of children with refractory Mycoplasma pneumoniae pneumonia (RMPP) and to improve the understanding and early diagnosis and treatment of RMPP. Methods 100 cases of MPP with different degree of pulmonary bronchoscopy hospitalized during 100 days before admission were selected and divided into RMPP group and MPP group according to the current relatively strict definition. The clinical data of two groups were compared Data and related laboratory tests commonly used indicators. Results (1) Clinical data: All the 100 children had fever and cough symptoms. There were 33 cases of RMPP, including 23 males and 10 females, and 26 cases (78.8%) were treated with glucocorticoid. 22 cases (66.7%); MPP 67 cases, including 35 males and 32 females, glucocorticoid in 41 cases (61.2%); After 48 h of glucocorticoid treatment, the body temperature dropped to normal in 9 cases in RMPP group and 30 in MPP group. The effective rate of hormones in MPP group was significantly higher (P <0.05). There was no significant difference in sex, age, azithromycin time, Bronchoscopy and other aspects of time differences were not statistically significant (P> 0.05). (2) Laboratory indicators: The amount of alveolar lavage fluid, mucus plug formation and poor ventilation in the two groups of children was statistically significant difference, RMPP children with C-reactive protein (CRP) and lactate dehydrogenase (LDH ) Were higher than those in MPP group, the difference was statistically significant (P <0.05). CONCLUSIONS: The above whole leaves are uniformly and densely transformed. The incidence of mucosal suppository and hypopnea of ​​high bacteria volume, bronchoscopy and CRP and LDH increased. The responsiveness to low-dose glucocorticoid therapy is the relevant index of RMPP, which should cause pediatricians The importance of.
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