肺炎支原体下呼吸道感染的临床特征分析

Epidemiological and clinical characteristics of mycoplasm pneumonia(MP) infection in community-acquired lower respiratory tract infection among hospitalized children

目的分析住院儿童社区获得性下呼吸道感染肺炎支原体(MP)的流行特点,提高对小儿MP肺炎的诊疗水平。方法回顾性分析2007年1月至2008年12月876例社区获得性下呼吸道感染(CALRTI)住院儿童的临床资料。采用被动颗粒凝集法检测患者急性期血清MP-IgM,滴度≥1:80为血清学诊断标准。结果876例患儿,急性MP感染177例(20.2%),6个月~14岁,平均5.1岁。3岁以上儿童占79.7%,有88/119例MP-IgM滴度≥1:320;3岁以下有25/58例,差异显著(χ2=16.1,P<0.005)。持续性咳嗽、发热是支原体下呼吸道感染的主要特征,但婴幼儿多见中度发热、喘憋多、肺部体征明显;胸部X线以支气管肺炎或间质性肺炎改变为主,大叶性肺炎改变很少;肺外并发症少。儿童期多见高热、干咳为主,咳嗽顽固剧烈,肺部体征少,胸片以大叶性改变为主,合并胸腔积液多,肺外并发症多。结论肺炎支原体是CALRTI住院儿童重要的致病原,多见于3岁以上儿童。MP感染率随年龄增高而升高,春、秋、冬季为感染发病高峰季节。婴幼儿与儿童MP感染的临床表现差异较大。

Objective To summarize the epidemiological and clinical characteristics of mycoplasm pneumonia(MP) infection in community-acquired lower respiratory tract infection(CALRTI) among hospitalized children.Methods A retrospective analysis of a database of 876 patients with CALRTI at the Qilu Hospital of Shandong University between 2007 and 2008 was performed.Serologic diagnosis for MP infection was made based on single titers ≥1∶80,which was measured by a passive particle agglutination test.Results MP infection ...