120例支原体、衣原体所致小儿肺炎临床分析

Clinical Analysis Of 120 cases Of Children Pneumonia Caused by the Mycoplasma and Chlamydia

目的：探讨小儿肺炎支原体肺炎（MP）、沙眼衣原体肺炎（CP）的临床特点，以提高对肺炎支原体、衣原体所致小儿肺炎的临床认识和诊治水平。方法：对2007年至2009年2年间收治的272例肺炎患儿的临床资料进行回顾性分析，并对不同年龄阶段惠儿进行分析。结果：272例肺炎患儿中肺炎支原体肺炎68例（25％），沙眼衣原体肺炎52例（19％），22例为混合感染18．3％（22／120）。肺炎支原体肺炎以5岁以上儿童多见（80％），5岁以下占20％。沙眼表原体肺炎以小婴儿多见，6月龄以下占63．4％。小儿肺炎全年均可发病，但以冬春季发病率最高。临床表现均以发热、咳嗽、气促、喘憋为主要症状，主要通过分别采用被动凝集法和改良间接固相酶联免疫吸附试验进行MP—IgM和CP—IgM检测以确诊。治疗沙眼表原体肺炎首选红霉素，支原体肺炎使用阿奇霉素治疗，疗效满意。结论：诊断为肺炎的患儿，在持续发热或反复咳嗽而疗效欠佳时，要尽早作血清学或病原学检查。以确诊或排除肺炎支原体肺炎及沙眼表原体肺炎，及时治疗。

Objective ： To investigate the Clinical characteristics of Children Mycoplasma pneumoniae （MP） and Chlamydia pneumoniae （ CP）, in order to improve the the level of clinical diagnosis and treatment of Mp and CP. Methods ： Retrospective analysis with different age groups in 272 cases of children pneumonia from 2007 to 2009. Results： In the 272 cases of children pneumonia, M P was observed in 25% （68/272）, CP in 19% （52/272）, and there were 22 eases have been found with mixed infection, in 18.3% （22/120）. MP have been found more in over 5 years old group（ 80% ） than under 5 years old group （ 20% ）. CP ofen have been found in infants ,the babies under 6 months accounted for 63.4%. Children pneumonia can be found all over the years, but the highest incidence is in winter and spring. The main Clinical performance are fever, cough, shortness of breath and asthmatic Symptoms. The diagnosis mainly through MP - IgM and CP - IgM detection respectively by passive agglutination , and enzyme - linked immunosorbent assay. Erythromyein as the first choice treatment for CP and Azithromycin for Mp with satisfactory efficacy. Conclusion： when the pneumonie children with fever or persistent cough and the efficacy was dissatisfied, we should do serelogieal examination or etiology check as soon as possible to rule out the diagnosis of MP or CP in order to timely treatment.