儿童肺炎支原体肺炎的临床特征分析
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儿童肺炎支原体肺炎的临床特征 分析
冯碧红 戴科娜 杨好好 宓科哲 施红波
浙江医学 2019 年第 41 卷第 11 期
荫临床研究
【 摘要 】 目的 探讨儿童肺炎支原体（MP）肺炎的临床特征。 方法 将确诊为 MP 肺炎的 228 例患儿，按年龄分为＜5 岁组 121 例、≥5 岁组 107 例，比较两组患儿临床表现、实验室及影像学检查结果。 结果 所有患儿无神经、肾脏、关节、皮肤等其他肺外 临床表现；与≥5 岁组相比，＜5 岁组患儿出现发热和 WBC 异常的比例明显降低（均 P＜0.05），而出现喘息、肺部啰音、肌酸激酶同工 酶（CK-MB）增高的比例明显增高（均 P＜0.05）；两组患儿 C 反应蛋白（CRP）增高、降钙素原（PCT）增高、ALT 增高的比例比较，差异 均无统计学意义（均 P ＞0.05）。两组患儿胸部 X 线片提示多有改变，＜5 岁组以肺部斑片状影多见（63.64%），≥5 岁组以肺部大片状 阴影多见（39.25%）；两组患儿胸腔积液的比例比较，差异无统计学意义（P ＞0.05）。 结论 儿童 MP 肺炎的临床表现多种多样，＜5 岁组患儿更易出现喘息、肺部啰音等局部症状，胸部 X 线片以肺部斑片状影多见；≥5 岁组患儿更易出现发热及胸部 X 线片肺部大片 状阴影。
【 Abstracቤተ መጻሕፍቲ ባይዱ 】 Objective To analyze the clinical characteristics of Mycoplasma pneumoniae (MP) pneumonia in children. Methods Clinical data of 228 children with MP pneumonia were retrospectively reviewed, including 121 cases aged ＜5 years and 107 cases aged ≥5 years. The clinical features, laboratory results and imaging findings were analyzed and compared between two age groups. Results There were no clinical manifestations of nervous system, kidney, joint and skin in all cases. Compared with the ≥5 years age group, the proportion of fever and abnormal WBC in the ＜5 years group was significantly lower, while the proportion of wheezing, pulmonary rales and increased creatine kinase isoenzyme-MB (CK-MB) level was significantly higher (P＜0.05). There were no significant differences in the percentage of increased CRP, PCT and ALT between the two groups (P ＞0.05). Chest X-ray showed that pulmonary patchy shadow was more common in ＜5 years group (63.64%) and pulmonary large patchy shadow was more common in ≥5 years group (39.25%). There was no significant difference in the proportion of pleural effusion between the two groups (P ＞0.05). Conclusion The clinical manifestations of MP pneumonia in children aged ＜5 years are prone to have local symptoms and pulmonary patchy shadow is more common in chest radiography; while children ≥5 years are prone to have fever and large infiltration shadows of chest radiography.
【 Key words 】 Child Mycoplasma pneumoniae pneumonia Clinical signs
肺炎支原体（mycoplasmapneumoniae，MP）是导致儿 童社区获得性呼吸道感染的重要病原体；在住院儿童 社区获得性肺炎中，占 10%~40%[1-2]。近年来，MP 肺炎 发病率明显上升，临床表现日益复杂。MP 感染会损害 呼吸系统，同时对肺外多种器官组织造成损伤，包括皮 肤黏膜、血液系统、心血管系统、消化系统、肌肉骨骼系 统和神经系统等[3]，严重时可威胁患儿生命。因此，了解
【 关键词 】 儿童 肺炎支原体肺炎 临床特征
Clinical features of Mycoplasma pneumoniae pneumonia in children FENG Bihong, DA I Kena, Y A NG Haohao, et al. Department of Pediatrics, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo 316000, China
DOI：10.12056/j.issn.1006-2785.2019.41.11.2019-818 作者单位：316000 宁波市医疗中心李惠利东部医院儿科 通信作者：冯碧红，E-mail：1329786286@
冯碧红 戴科娜 杨好好 宓科哲 施红波
浙江医学 2019 年第 41 卷第 11 期
荫临床研究
【 摘要 】 目的 探讨儿童肺炎支原体（MP）肺炎的临床特征。 方法 将确诊为 MP 肺炎的 228 例患儿，按年龄分为＜5 岁组 121 例、≥5 岁组 107 例，比较两组患儿临床表现、实验室及影像学检查结果。 结果 所有患儿无神经、肾脏、关节、皮肤等其他肺外 临床表现；与≥5 岁组相比，＜5 岁组患儿出现发热和 WBC 异常的比例明显降低（均 P＜0.05），而出现喘息、肺部啰音、肌酸激酶同工 酶（CK-MB）增高的比例明显增高（均 P＜0.05）；两组患儿 C 反应蛋白（CRP）增高、降钙素原（PCT）增高、ALT 增高的比例比较，差异 均无统计学意义（均 P ＞0.05）。两组患儿胸部 X 线片提示多有改变，＜5 岁组以肺部斑片状影多见（63.64%），≥5 岁组以肺部大片状 阴影多见（39.25%）；两组患儿胸腔积液的比例比较，差异无统计学意义（P ＞0.05）。 结论 儿童 MP 肺炎的临床表现多种多样，＜5 岁组患儿更易出现喘息、肺部啰音等局部症状，胸部 X 线片以肺部斑片状影多见；≥5 岁组患儿更易出现发热及胸部 X 线片肺部大片 状阴影。
【 Abstracቤተ መጻሕፍቲ ባይዱ 】 Objective To analyze the clinical characteristics of Mycoplasma pneumoniae (MP) pneumonia in children. Methods Clinical data of 228 children with MP pneumonia were retrospectively reviewed, including 121 cases aged ＜5 years and 107 cases aged ≥5 years. The clinical features, laboratory results and imaging findings were analyzed and compared between two age groups. Results There were no clinical manifestations of nervous system, kidney, joint and skin in all cases. Compared with the ≥5 years age group, the proportion of fever and abnormal WBC in the ＜5 years group was significantly lower, while the proportion of wheezing, pulmonary rales and increased creatine kinase isoenzyme-MB (CK-MB) level was significantly higher (P＜0.05). There were no significant differences in the percentage of increased CRP, PCT and ALT between the two groups (P ＞0.05). Chest X-ray showed that pulmonary patchy shadow was more common in ＜5 years group (63.64%) and pulmonary large patchy shadow was more common in ≥5 years group (39.25%). There was no significant difference in the proportion of pleural effusion between the two groups (P ＞0.05). Conclusion The clinical manifestations of MP pneumonia in children aged ＜5 years are prone to have local symptoms and pulmonary patchy shadow is more common in chest radiography; while children ≥5 years are prone to have fever and large infiltration shadows of chest radiography.
【 Key words 】 Child Mycoplasma pneumoniae pneumonia Clinical signs
肺炎支原体（mycoplasmapneumoniae，MP）是导致儿 童社区获得性呼吸道感染的重要病原体；在住院儿童 社区获得性肺炎中，占 10%~40%[1-2]。近年来，MP 肺炎 发病率明显上升，临床表现日益复杂。MP 感染会损害 呼吸系统，同时对肺外多种器官组织造成损伤，包括皮 肤黏膜、血液系统、心血管系统、消化系统、肌肉骨骼系 统和神经系统等[3]，严重时可威胁患儿生命。因此，了解
【 关键词 】 儿童 肺炎支原体肺炎 临床特征
Clinical features of Mycoplasma pneumoniae pneumonia in children FENG Bihong, DA I Kena, Y A NG Haohao, et al. Department of Pediatrics, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo 316000, China
DOI：10.12056/j.issn.1006-2785.2019.41.11.2019-818 作者单位：316000 宁波市医疗中心李惠利东部医院儿科 通信作者：冯碧红，E-mail：1329786286@