肺炎支原体感染肺外损害58例分析

An Analysis of the Damage of Extra-pulmonary Organs in Children with Mycoplasma Pneumonia Infection

目的 分析小儿肺炎支原体 (MP)感染并发肺外脏器损害的临床特征和治疗结果。方法 对确诊为MP感染的 12 6例患儿进行回顾性临床分析。结果 上呼吸道感染 2 0例 ,下呼吸道感染 10 6例 ;并发肺外损害 5 8例(4 6 % ) ,其中 4～ 14岁患儿 5 2例 (89 7% ) ,最小年龄 5个月 ;损害以消化、泌尿、心血管、神经和血液系统为多见 ,分别占 37 9%、 30 0 %、 2 4 1%、 15 5 %、 13 8% ,皮肤黏膜及关节肌肉损害分别占 8 6 %、 5 7% ;所有患儿经阿奇霉素治疗 ,效果良好。结论 小儿MP感染的临床特征及胸部X线表现缺乏特异性 ,肺外损害发生率较高 ,以肺外并发症为首发症状时 ,易造成误诊。对可疑MP感染者 ,应及时检测血MP -IgM ,尽早诊断和治疗。

Objective To analyze clinical characteristics of the organs damage out of lung caused by mycoplasma pneumonia(MP) infection in children and the effect of treatment.Methods To have a clinical review for 126 cases of children who are confirmed mycoplasma pneumonia infection retrospectively.Results 20 cases were infected in the upperrespiratory tract and 106 cases in the lower respiratory tract.58 cases (46%) were accompanied by organ damages out of lung, including 52 cases (89.7%) from the age of 4 to 14 years old and the lowest age was 5 months. The organ damages out of lung were observed mostly in gastrointestinal system (37.9%), urinary system (30%), cardiovascular system (24.1%), neurological system (15.5%) and blood system (13.8%).The rate of damages in skin-mucous membrane and joint-muscle were 8.6% and 5.7%, respectively. Azithromycin is effective in all patients.Conclusion The clinical characteristics of children with mycoplasma pneumonia infection and X-ray exam in chest usually lacked special characteristics, the rate of organ damage out of respiratory tract is high in children with mycoplasma pneumonia infection. Mistake may occur easily in diagnosis if the symptoms out of lung appear first. So, the suspicious inflection patients should be tested by special MP-lgM in serum in time, diagnosed and treated as early as possible.