肺炎支原体感染与小儿喘息发生的关系

Relationship between mycoplasma pneumonia infections and wheezing in children

目的探讨肺炎支原体（mycoplasma pneumonia，MP）感染是否诱发小儿喘息。方法用颗粒凝集法检测2007年我院儿科住院部因呼吸道感染性疾病发生喘息而收治的70例患儿及非呼吸道感染性疾病患儿17例的MP-IgM抗体效价，对比喘息组及对照组之间MP-IgM的阳性率，同时比较喘息组各年龄段MP—IgM阳性率的差异以及大环内酯类抗生素在喘息组中的疗效和支原体表达的相关性。结果70例患儿中39例MP-IgM阳性，阳性率为55．7％，对照组17例患儿MP-IgM阳性仅4例，阳性率为23．5％（Х^2=5．668，P=0．017）；喘息患儿中1-3岁年龄段MP-IgM阳性率最高，为27．1％，〈1岁患儿阳性率最低，仅4.3％（Х^2=30．8，P〈0．001）；〈1岁组MP-IgM阳性率显著低于1岁以上组（Х^2=30．119，P〈0．001）；1-3岁组和〉3岁组间MP—IgM阳性率无显著性差异（Х^2=1．089，P=0．297）。喘息患儿中MP-IgM阳性者使用大环内酯类抗生素治疗的有效率为94．9％，而MP-IgM阴性者有效率为29．0％（Х^2=37．7，P〈0．001）。结论肺炎支原体感染可诱发小儿发生喘息，尤其是〉1岁的小儿发生率较高，呼吸道感染诱发喘息者，需要考虑存在支原体感染的可能性。

Objective To investigate the relationship between mycoplasma pneumonia （MP） infections and wheezing in children. Methods Seventy patients of respiratory tract infectious diseases with wheezing and seventeen patients with negative respiratory tract infectious diseases who had been serologically tested for MP-IgM antibody titer by using particle diameter agglutination were enrolled in admission department of pediatrics in our hospital in 2007. The positive rate of MP-IgM of the two groups and that of the wheezing group in different ages were compared. The curative effect of macrolide antibiotic and the dependability of MP infection in wheezing group were compared. Results MP-IgM antibody titer of thirty nine were positive in wheezing group, the positive rate was 55.7%; there were only 4 patients whose MP-IgM was positive in control group, the positive rate is 23.5% （Х^2=5.668, P=0.017）; MP-IgM positive rate of the wheezing group in one to three years old stage was the highest, it was 27.1%, but that was the lowest below one years old, only 4.3% （Х^2=30.8, P〈0.001 ）. MP-IgM positive rate below one years old is lower than that of exceed one years old （Х^2= 30.119, P〈0.001 ） ; MP-IgM positive rate is not difference between one to three years old and exceed three years old （Х^2=1.089, P=0.297） . The effective power of the macrolide antibiotic whose positive MP-IgM in wheezing group is 94.9%, but that of is 29.0% in negative MP-IgM （Х^2=37.7, P〈0.001） . Conclusions MP Infection may induce wheezing. Especially, the incidence rate is higher in exceed one years old children. We should consider the possibility of MP infection when respiratory tract infection with wheezing.