小儿下呼吸道肺炎支原体感染136例分析

Analysis 136 cases of mycoplasma pneumoniae infection in lower respiratory of children

目的提高对肺炎支原体（MP）感染的临床认识，合理诊治MP，合理使用抗生素以减少耐药性的发生。方法对2005年3月至2008年2月上海第八人民医院收治的136例下呼吸道肺炎支原体感染病例，对其临床过程、实验室检查和治疗措施进行总结和分析。结果发病年龄多为学龄儿，早期无明显阳性体征，MP痰液培养阳性率低，仅占3．9％；外周血白细胞多正常，占70．6％；但CRP升高，占44．1％；胸片表现有多样性，30例有不同程度肺外表现，其中主要是渗出性胸膜炎，占13．2％。治疗用阿奇霉素效果良好，总有效率达96．7％。结论MP感染好发于学龄儿，MP—IgM阳性率高，占85．3％。阿奇霉素治疗疗程短、疗效好。对MP感染应尽量做到早期诊断，合理使用大环内酯类抗生素，并加强对MP感染耐药性的检测有非常重要的现实意义。

Objective Enrich knowledge of Mycoplasma pneumoniae infection; try to find the best way to therapy and diagnosis MP, and how to use antibiotics rationally to reduce the antibiotics resistance. Methods Collected 136 cases of MP infection in lower respiratory of children. The clinical course, laboratory investigation,therapy of these patients were retrospectively reviewed and analysis. Results School-age children were more like to get the disease. This disease has no obviously positive characteristics earlier. MP were isolated and identified. There were lower positive rate in spittle culture, only being 3.9%. Most of them the WBC of blood were in normal level, being 70. 6% But the CRP were rise, being 40. 1%. The X-rays were various. 30 cases out of 136 had medical complications out of the lungs. There were higher response of using azithromycin, being 96.7%. Conclusion MP infect often occur to school-age children. And the positive rate of MP-IgM was higher, being 85. 3%. Usage of azithromycin can reduce the course of treatment, and the function curative effect was better. But we should diagnosis MP as possible as earlier, and use macrolides antibiotics rationally ; there are very important realistic significance to strengthen to check of the antibiotic resistance of MP infection.