小儿肺炎支原体中枢感染40例临床分析

Central Nervous Infection of Mycolasma Pneumonia in Children: 40 Cases Report

目的:分析肺炎支原体(Mp)感染所致的脑炎的临床特点,提高对本病的认识水平并探讨早期诊断的临床意义。方法:对40例确诊为肺炎支原体感染,且有神经系统损害的患儿回顾性进行临床分析。结果:40例中29例有不同程度的发热,14例有抽搐,22例呕吐,10例头痛,36例脑电图异常,确诊为Mp感染后,均用大环内酯类阿齐霉素治疗,并辅以支持、对症治疗,住院2-20 d,平均15.5 d,其中29例治愈,18例好转,出院后门诊随访观察,辅以高压氧和康复治疗,治疗3-6个月,全部恢复正常,余3例放弃治疗。结论:肺炎支原体感染所致的中枢感染,诊断需具备血清Mp-IgM阳性、脑脊液检查病脑改变及神经系统受累表现的临床症状,阿齐霉素治疗效果确切,预后良好。

Objective： To review the clinic features of children＇s central nervous infection with Mycolasma Pneumoniae （Mp）. Methods： The clinic data of 40 cases of Mp infected children with central nervous infection were analyzed. There were 29 cases with fever, 14 with muscular spasm, 10 with headaches and 36 cases with abnormal electroencephalogram. All patients were treated with Azithromycin for 2-20 days in hospital, and followed with hyperbaric oxygen and physical therapy for 3-6 months. Results： Of the 40 cases, 29 were cured and 18 showed improvement after Azithromycin treatment, and all cases were cured after the following therapy except three cases had given up. Conclusion： The diagnosis of central nervous infection with Mp was established by the positive results in serum Mp-IgM detection, cerebrospinal fluid changes and symptoms of nervous damages. The treatment with Azithromycin was effective and showed good prognosis in this disease.