支原体肺炎与毛细支气管炎的临床研究

A study on clinical features of bronchiolitis and mycoplasmas pneumonia in infant

目的探讨肺炎支原体(MP)感染与毛细支气管炎的相关性,分析其临床特点。方法对186例毛细支气管炎患儿血清采用酶联免疫法(ELISA)MP-IgM检测,MP-IgM阳性为MP感染(感染组),MP-IgM阴性为对照组,对两组进行比较分析。结果感染组64例(34.4%),其中年龄<6个月13例(20.3%),～2岁51例(79.7%),冬春发病38例(59.4%),夏秋26例(40.6%)。对照组122例,其中年龄<6个月78例(63.9%),～2岁44例(36.1%),冬春发病112例(91.8%),夏秋10例(9.2%)。两组发病年龄和发病季节均有显著性差异(P<0.01)。两组患儿均有咳嗽、喘憋及呼吸困难,与对照组比较,MP感染组中高度发热62例(96.9%)、肺部X线片状阴影48例(75%),均高于对照组,有显著性差异(P<0.01)。CRP、白细胞总数(WBC)两组无显著性差异。并发症发生率,MP感染组18例(28.1%),对照组19例(15.5%),P<0.05。结论以中高度发热,且持续时间较长,肺部X线有片状阴影的毛细支气管炎患儿,应疑为MP感染及时进行MP抗体的检查,早期作出诊断与治疗。

Objective To study the relation olitis and mycoplasmas pneumonia （MP） in infants. of the clinical features on bronchi- Methods The blood serum MP-IgM of 186 young children with bronchiolitis were detected with ELISA test, according to results of MP-IgM were divided into MP-IgM positive group and MP-IgM negative group.The clinical features in two groups were conducted comparative analysis. Results In 186 patients with bronchiolitis 64 cases were MP-IgM positive（34.4%）, age under 6 months was 13 cases （20.3%）, from 6 months to 2 years 51 cases （79.7%）, at the onset 38 cases （59,4%） were in winter and spring, 26 cases （40.6%） in summer and autumn. MP-IgM negative group was 122 cases, under 6 months was 78 cases（63.9）, 6 months to 2 years 44 cases （36.1%）, 112 cases（91.8%） in winter and spring, 10 cases（9.2%） in summer and autumn. In positive group the fever of mid-high was 62 cases （96.9%）, CRP positive rate 21.9%（14 cases）, WBC over 10 × 10^9/L 10 cases（15.6%）, and the shadow area of chest in the roentgenogram was found in 48 cases （75%）. The incidence of complication in positive group was 18 cases（28.1%）, and negative group only 19 cases（15.5%）（P〈0.01）. Conclusion The bronchiolitis in young children have higher fever with longer period dyspnea and the shadow area of chest etc. may raise the suspition of MP and detecte the MP-IgM in serum in time to get early diagnosis and treatment.