肺炎支原体引起小儿上呼吸道感染的临床研究

Childhood upper respiratory infection caused by Mycoplasma pneumoniae

目的研究肺炎支原体引起小儿上呼吸道感染的发病率及临床特点和转归。方法随机对门急诊患急性上呼吸道感染的960例小儿取咽拭子做肺炎支原体培养,以100例健康小儿为对照组。结果观察组咽拭子肺炎支原体阳性率31.7%,明显高于对照组的9%(P<0.01),婴儿组阳性率明显低于1岁以上各年龄组(P<0.05);肺炎支原体阳性患儿与阴性患儿的相比,咳嗽、扁桃体红肿的比例高(P<0.05),发热、卡他症状、胃肠道症状、疱疹、皮疹等症状体征少(P<0.01);14.8%的阳性患儿发展为肺炎,明显高于阴性组(P<0.01)。结论肺炎支原体是小儿急性上呼吸道感染的主要病原体之一,好发于1岁以上小儿,主要表现为急性咽扁桃体炎的症状,较易发展为肺炎。

Objective This study was designed to investigate the prevalence, clinical characteristics and outcome of upper respiratory infection （URI） caused by Mycoplasma pneumoniae （MP） in children. Methods Pharyngeal cultures for MP antibody were performed in 960 children with acute URI. The samples were randomly collected from the outpatient room or emergency room （ Observed group）. Of the Observed group, there were 232 cases under 1 year of age, and the remainder, were between 1-12 years old. The samples from 100 healthy children aged from 6 months to 12 years were used as the Control group. The prevalence of MP infection between the two groups was compared. The clinical manifestations and the outcome between the patients with MP positive and negative were compared. Results MP antibody was positive in 31.7% （304/960） of the Observed group but only 9.0% （9/100） in the Control group （P 〈0.05）. The URI patients under 1 year of age had a lower positive rate of MP than those over 1 year old （ P 〈 0.05 ）. Coughs and tonsillitis were more common （P 〈0.05）, but catarrh, gastroenteritic symptoms, herpes, and tetter were rare （P 〈0.01 ） in URI patients with MP positive compared with those with MP negative. Pneumonia developed in 14.8% of the patients with MP positive but only 7.0% in those with MP negative （ P 〈 0.01 ）. Conclusions MP is one of the main pathogens of acute URI in children. Acute pharyngotonsillitis symptoms are predominately presented in children with MP infection. MP infection was commonly seen in children over 1 year old and they are prone to develop pneumonia.