儿童肺炎支原体肺炎临床变化特征

Child pneumonia Mycoplasma pneumonia clinical change characteristic

目的:总结4年来德阳地区3岁以上儿童肺炎支原体(MP)肺炎临床变化特征。方法:2006年1月-2010年9月收治的3岁以上MP肺炎患儿200例,比较3个时间段(2006-2008年,2008-2009年,2009-2010年)MP肺炎的临床表现、胸X线片及治疗转归的变化趋势。结果:①发热与热程变化:共196例患儿有不同程度的发热,占98%,不同时段患儿热程中位数分别为7.1d、8.4d和11.1d,差异有统计学意义(P<0.01)。②呼吸道症状:3个时段患儿呼吸道症状包括喘息/呼吸困难(6.0%,9.8%,16.1%)、寒战(6.8%,11.2%,19.9%)、胸痛(12.1%,15.4%,20.2%)发生率比较差异有统计学意义(P<0.05)。③3个时段肺外损害发生率(13.1%、38.1%、48.7%)差异有统计学意义(P<0.01)。④胸部Ⅹ线片改变:主要表现为大片状阴影,2009-2010年30.1%患儿伴有胸腔积液、肺不张等肺内并发症,不同时间段比较差异有统计学意义(P<0.01)。⑤治疗与转归:红霉素和阿奇霉素对MP肺炎的治疗效果在不同时段间比较,有效率逐渐下降。经大环内酯类药物治疗后发热的持续时间中位数分别为3.2d、4.5d、6.3d,住院天数中位数分别为7.1d、8.6d、11.5d,差异有统计学意义(P<0.05)。结论:2006-2010年德阳地区3岁以上儿童MP肺炎呈现发热时间延长,呼吸道症状加重,并发症和肺外损害发生率增加,难治和重症MP肺炎病例明显增多。

Objective：Summarizes above for 4 year Deyang area 3 years old the child pneumonia mycoplasma （MP） pneumonia clinical change characteristie. Methodsin ： January,2006 - September, 2010 admits above 3 years old the MP pneumonia baby 200 examples, compared with 3 time sections （2006 - 2008 years,2008 -2009 years, the change tendency which 2009 -2010 years） the MP pneumonias clinical manifestation, the chest X piece and the treatment extension turns over. Resuits ：（1）Gives off heat with hot Cheng Bianhua ： Altogether 196 example babies have the varying degree to give off heat account for 98%, the different time interval baby hot regulation median respectively is 7. I d,8.4d and 11. I d, the difference has statistics significance （ P 〈 0. 01 ）. （2）Respiratory symptom ：3 time interval baby respiratory symptom including pants for breath/the scant of breath （6.0% ,9.8% , 16.1% ） ,to shiver （6.8% ,11.2% , 19.9% ） ,chest pain （ 12.1% ,15.4% ,2（12% ） the formarion rate comparison difference has statistics significance （ P 〈0.05 ）. （3）outside 3 time interval lungs harms the formation rate （ 13.1% ,38.1% ,48.7% ） difference to have statistics significance （P 〈 0.01 ）. （4）Chest X Line piece change ：The main performance for the big laminated shadow,2009 - 2010 year 30.1% baby is accompa- nied by the chest cavity to accumulate the fluid, the lung not to open and so on the lungs the complication, is different when the compartment comparison difference has statistics significance （ P 〈 0.01 ）. （5）The treatment and the extension turn over to ： The erythromycin and the arch mildew element to the MP pneumonias treatment result during the different time interval the comparison, effectiveness drop gradually. After large ring lactone class pharmacological treatment gives off heat the duration median respectively is 3.2d,4.5d ,6.3d, in hospital number of days median respectively is 7.1 d, 8.6d, 11.5d, the difference has statistics significance （ P 〈 0.05 ）. Conclusions：Above 2006 -2010 year Deyang area 3 years old the child MP pneumonia presents the giving off heat time expand, the respiratory symptom aggravates,outside the complication and the lung harms the formation rate to increase, difficult to govern with the critically ill MP pneumonia case increases obviously.