儿童肺炎支原体肺炎临床特征及肺外并发症438例分析

Clinical features and extrapulmonary complications of Mycoplasma pneumoniae in children:Report of 438 cases

目的:探讨儿童肺炎支原体(MP)肺炎临床及肺外并发症的特点。方法:分析438例儿童MP肺炎的临床特点及肺外并发症的发生情况。结果:438例中319例为学龄前期(3～6岁);153例肺外并发症中年龄≥3岁143例,3岁以下10例;并发症中以心血管、消化、神经系统多见,分别为51.0%、29.4%、17.6%;所有病例经阿奇霉素治疗14天左右好转。辅助检查:血MP-IgM均≥1∶80,咽拭子MP培养阳性率32.6%。胸片肺间质改变238例,肺泡炎症121例,混合病变79例。结论:MP感染临床特征及胸部X线表现缺乏特异性,且易有肺外并发症,以肺外并发症为首发症状时,易造成误诊;对于治疗不理想且伴有肺外并发症的肺炎,应考虑MP感染可能,及时进行相关检测,早确诊,早治疗。

Objective：To explore the clinical manifestations and extrapulmonary complications of Mycoplasma pneumoniae（MP）in children.Methods：The clinical data of 438 cases of children MP were analyzed retrospectively.Results：Three hundred nineteen of all the MP cases were preschool-age children（3-6 years）.Among the 153 cases of extrapulmonary complications,143 cases were no less than 3 years of age and 10 cases were under 3 years.The complications occurred mostly in the circulative system,digestive system and nervous system（51.0%,29.4% and 17.6%,respectively）.All the cases improved after being treated with Azithromycin for 14 days.Assistanted examination showed that the blood MP-IgM in all the cases was ≥1∶80 and MP culture positive rate was 32.6%.Carinii pneumonia changes was seen in 238 cases,alveolus inflammation in 121 cases and mixed pathological changes in 79 cases.Conclusions：Clinical and chest radiograph examination of MP infection absents speciality and is apt to extrapulmonary complications.If extrapulmonary complication is its first symptom,error diagnosis is commonly inevitable.If the pneumonia presents no ideal treatment changes and is accompanied by extrapulmonary complications,MP infection must be considered.In the same time,related examinations must be conducted to achieve early diagnosis and treatment.