儿童肺炎支原体肺炎392例临床分析

Clinical analysis of 392 cases of children with mycoplasma pneumonia

目的探讨儿童肺炎支原体肺炎（MPP）的临床特点及治疗方法。方法对196例确诊为MPP患儿的临床特点进行回顾性分析。结果本组患儿以1～3岁的婴幼儿为主。发热162例（82．65％），持续性咳嗽124例（63．27％）。多数肺部可闻及湿哕音，两肺呈斑片状阴影105例（53．57％），呈间质性损害35例（17．86％），大片状阴影23例（11．73％）。多数患儿（60．71％）外周血白细胞总数正常。肺外并发症主要消化系统、心血管系统、皮肤、黏膜、中枢神经系统和泌尿系统损害。血清肺炎支原体特异性IgM抗体（MP—IgM）均阳性。所有病例用阿奇霉素治疗2～3周均治愈。结论儿童MPP好发于婴幼儿，肺外并发症可累及多个系统，血清学MP—IgM检测是早期诊断的必要手段，阿奇霉素是有效的治疗药物。

Objective To study the clinical characteristics and treatment of children with mycoplasma pneumonia （MPP）. Method The clinical data of 196 cases of children with MPP were analyzed retrospectively. Results The majority cases aged 1 to 3 years. There were 162 cases with fever （ 82. 65% ） , 124 cases with persistent cough （63.27%）. There were moist rales heard over the lungs in the majority cases. Chest radiography showed mottling in 105 cases （53. 57% ） , interstitial lung lesions in 35 cases （ 17. 86% ）, and large plaque - like shadows in 46 cases （11.73% ）. The majority cases had normal total WBC count. The extrapulmonary complications occurred mainly in the digestive system, circulation system, mucocutaneous system, central nervous system, and urinary system. All the cases showed a positive serum mycoplasma pneumoniae IgM （ MP - IgM）. All the cases were cured after being treated with az- ithromyein for 2 - 3 weeks. Conclusion The majority children with MPP are 1 to 3 years of age. The extrapulmonary complications can occur in multiple systems. The test of serum MP - IgM should be conducted for early diagnosis. Azithromycin is an effective agent to treat MPP.