小儿肺炎支原体感染调查分析

Clinical Analysis of Children with Mycoplasma Pneumoniae Infection

目的分析各年龄段儿童肺炎支原体(MP)感染的流行病学特征、临床特点及治疗效果。方法采用明胶凝集法检测血MP-IgM,对MP-IgM>1∶40确诊为MP感染的482例患儿进行回顾性分析。结果482例患儿中有154人(32.0%)有明确的肺炎支原体感染接触史,其中年龄<3岁78例(50.6%),2岁以下的婴幼儿64例中有51例(79.7%)其家庭成员或带养者中至少有一人肺炎支原体抗体呈现阳性,近2周内有临床症状的有42例(65.6%)。共有223例(46.3%)伴有不同程度的肺外并发症,3岁以下的婴幼儿并发症发生率为19.2%,4岁以上患儿为51.5%。受累脏器中以消化、心血管、血液系统和皮肤多见,神经系统少见;累积两个以上器官的占28.7%。全部病例均采用综合治疗,抗菌素治疗采用阿奇霉素序贯疗法,疗程3～4周,全部患儿均痊愈出院,无明显不良反应。所有病例均随访1年,33%的患儿3个月MP-IgM滴度降至正常,52.3%于3～6个月降至正常。3个月内复发率为3.1%。结论MP感染易误诊,对于短期内病情易反复者应追问有无流行接触史,并及早进行MP-IgM检测以确诊。MP感染易出现肺外脏器受累,规范治疗可以减轻患儿的肺外损害,减少复发。

Objective To analyze the epidemiology and clinical characteristics of Mycoplasma Pneumoniae（MP） infection in hospitalized children of each age groups. Methods The gelatin agglutination test were used to detected the MP-IgM. The clinical data of 482 children with MP infection confirmed by MP-IgM （above 1： 40） were analyzed retrospectively. Results 154 children （32.0%） had a clear contact history of MP infection. 223 children（46.3% ） had complications from those organs except lung. The organs included alimentary system, circulatory system, blood system, skin, nervous system, etc. All children were given a complex treatment,azithromycin sequential therapy was used as anti-inflammatory treatment, the treatment course was 3 to 4 weeks and all children were cured. All patients were followed-up for one year, no adverse reaction was observed and the recurrence rate was 3.1% in three months. Conclusion MP infection is easily misdiagnosed. We should acquire the epidemic history of patients in time and test blood MP-IgM in patients with a long time fever and cough. MP infection may easily cause harms in some organ, the regular treatment can release these harm.