儿童肺炎支原体下呼吸道感染的临床特征分析

Analysis of clinical characteristics in children with lower respiratory tract infection of mycoplasma pneumoniae

目的:了解儿童肺炎支原体(Mycoplasma pneumoniae,MP)下呼吸道感染的临床特征。方法:回顾性分析2008年1月～2009年4月本院呼吸1病房确诊为MP下呼吸道感染的211例住院患儿临床资料,分析总结MP下呼吸道感染患儿年龄、临床症状体征、胸部X线、肺功能以及实验室检查等特征。结果:MP下呼吸道感染男女无明显差异,5岁以下儿童占71.1%,咳嗽率98.6%,发热率75.4%,喘息率51.2%,婴幼儿喘息发生率明显高于年长儿(62.4%vs 39.2%,P=0.001),呕吐腹泻率明显高于年长儿(35.8%vs 14.7%,P=0.000 1),皮疹发生率明显高于年长儿(14.7%vs 5.9%,P=0.037),MP感染患儿中60.7%合并肺炎衣原体(Chlamydia pneumoniae,CP)感染,50.0%合并细菌感染,26.9%合并病毒感染。肺功能检查提示90.3%(65/72)有不同程度的气道阻塞,70.8%(17/24)有气道高反应性。结论:小儿MP下呼吸道感染年龄呈低龄化趋势,以咳嗽、发热、喘息为主要表现,婴幼儿较年长儿更易出现喘息、呕吐腹泻及皮疹。MP感染易合并CP感染,可引起气道阻塞和气道高反应性。

Objective：To understand the clinical characteristics of lower respiratory tract infection caused by mycoplasma pneumoniae （MP）in children. Methods：Clinical data of 211 in-patients diagnosed with mycoplasma pneumoniae-caused lower respiratory tract infections from the first respiratory ward of our hospital from Jan.2008 to Apr.2009 was analyzed retrospectively to figure out the feature of the patient’s age,clinical symptoms and signs,chest X-ray,pulmonary function and other laboratory results. Results：There was no significant difference between different gender in patients with mycoplasma pneumoniae-caused lower respiratory tract infection,among the patients,there were 71.1% of them were under 5 years of age,rate of patients under through cough,fever and wheezing were 98.6%, 75.4% and 51.2% respectively. Rate of infants suffered from wheezing were significantly higher than older children （62.4% vs 39.2%, P=0.001）,rate of infants suffered from vomiting and diarrhea was higher than older children （35.8% vs 14.7%,P=0.000 1）,and rate of infants suffered from rash was higher than older children（14.7% vs 5.9%,P=0.037）. There were 60.7% mycoplasma pneumoniae patients combined chlamydia pneumoniae （CP） infection,50.0% of them combined bacterial infection,and 26.9% of them combined virus infection. Pulmonary function tests indicated that there were 90.3%（65/72）patients developed airway obstruction in varying degrees,and there were 70.8% （17/24）patients suffered from airway hyper-responsiveness. Conclusion：Younger children are more susceptible to Mycoplasma pneumoniae-caused lower respiratory tract infection,and the most common symptoms of which were cough,fever and wheezing. Compared with older children,infants developed wheezing、vomiting、diarrhea and rash more probablely. Mycoplasma pneumoniae infection often combined with chlamydia pneumoniae infection , which might be the cause of airway obstruction and airway hyper-responsiveness.