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目的:探讨肺炎支原体(MP)引起的中枢神经系统(CNS)感染的临床表现、诊断及治疗。方法:分析20例MP引起的CNS感染患儿的临床资料,总结小儿CNS MP感染的临床特点。结果:20例中14例以呼吸道症状起病者在病程第10天左右出现神经系统症状,检测血MP特异性IgM抗体阳性,而脑脊液(CSF)MP DNA阴性;6例以神经系统症状起病,检测血MP特异性IgM抗体阴性,但CSF MP DNA阳性。以呼吸道症状起病者平均住院(15~30)d,而以神经系统症状起病者平均住院(8~15)d。结论:MP是引起儿童CNS感染的病原体之一,CNS症状可在肺炎病程中或无肺部症状时出现,其临床症状与病毒性脑炎鉴别困难。CNS MP DNA检测阳性及血清特异性IgM抗体增高,对确诊MP感染、指导治疗有重要意义。MP CNS感染通常预后良好。
Objective: To investigate the clinical manifestations, diagnosis and treatment of central nervous system (CNS) infection caused by Mycoplasma pneumoniae (MP). Methods: The clinical data of 20 children with CNS infection caused by MP were analyzed, and the clinical features of children with CNS MP infection were summarized. Results: Among the 20 patients, 14 patients with respiratory symptoms developed neurological symptoms on the 10th day of the course of disease, blood-specific IgM antibodies were detected, and MP DNA of cerebrospinal fluid (CSF) was negative. Six patients with neurological symptoms , Blood was tested for MP-specific IgM antibody negative but CSF MP DNA was positive. The average number of hospitalizations (15-30) for patients with respiratory symptoms and the average number of hospitalizations for those with neurological symptoms (8-15) d. Conclusion: MP is one of the pathogens causing CNS infection in children. CNS symptoms may occur in the course of pneumonia or without pulmonary symptoms, and its clinical symptoms are difficult to identify with viral encephalitis. CNS MP DNA test-positive and serum-specific IgM antibodies increased, the diagnosis of MP infection, guiding the treatment of great significance. MP CNS infections usually have a good prognosis.