儿童肺炎支原体肺炎的常规肺功能变化及临床意义

Study on the changes of general pulmonary function in children with mycoplasma pneumoniae pneumonia

目的:观察儿童肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)的常规肺功能动态改变特点,并探讨其临床意义。方法:采用JEAGER公司生产的Master Screen Paed肺功能仪,检测分析58例MPP患儿的急性期、恢复期的常规肺功能和41例门诊健康体检儿童的常规肺功能,并加以比较。结果:①58例MPP患儿急性期的常规肺功能结果报告显示,20例(占34.48%)肺功能正常,余38例(占65.52%)均有不同程度肺功能损害,表现为小气道通气功能障碍31例(占53.45%)、限制性通气障碍1例(占1.72%)、阻塞性通气障碍1例(占1.72%)和混合性通气障碍5例(占8.62%)。恢复期常规肺功能结果报告显示,小气道通气功能障碍6例(占10.34%),其余肺功能均恢复正常(占89.66%)。②将58例MPP患儿的急性组、恢复组和41例正常组比较,急性组的各项常规肺功能指标如FVC、FEV1、FEV1/FVC、PEF、FEF25、FEF50、FEF75、FEF25-75,与恢复组、正常组比差异均有统计学意义(P<0.05)。恢复组与正常组比较,除FEF75、FEF25-75仍低于正常组(P<0.05)外,其余指标差异无统计学意义。结论:MPP患儿急性期大小气道通气功能均有损害,除FEF75、FEF25-75两项小气道通气功能指标仍显著低于正常组外,其余指标均恢复正常。我们认为动态观察MPP患儿肺功能的变化,对了解MPP患儿肺功能的损害程度、疗效、预后有一定意义。

Objective： To observe the dynamics of general pulmonary function in children with mycoplasma pneumoniae pneumonia and to explore the clinical significance.Methods： The general pulmonary funotion of 58 children with mycoplasma pneumoniae pneumonia during acute phase and during admission phase and the general pulmonary function of 41 normal children were tested using Master Screen Paed System.Results： ①The general pulmonary function of 58 children with mycoplasma pneumoniae pneumonia during acute phase were reported that twenty of 58 cases（34.48%） were normal and thirty-eight of 58 cases（65.52%）were abnormal.31/38 cases（53.45% 31/58）had small airway dysfunction,1/58 cases（1.72%）had restricted ventilatory disturbance,1/58 cases（1.72%）had obstructive ventilatory disturbance and 5/58 cases（8.62%）had mixed ventilatory disturbance.②During the acute phase of mycoplasma pneumoniae pneumonia,FEV1、FEV1/FVC、PEF、FEF25、FEF50、FEF75、FEF25-75 were significantly decreased compared with those in admission phase and normal group.In admission phase,FEF75、FEF25-75 were significantly decreased com-pared with normal group.The other targets showed no statistically significant differences compared with normal group.Conclusion： In the acute phase of mycoplasma pneumoniae pneumonia higher resistance exists in big and small airways and most commonly have small airway dysfunction.Most targets are improved during admission phase,excluding FEF75、FEF25-75.General pulmonary function test is a valuable way for surveillance of the course and prognosis of mycoplasma pneumoniae pneumonia.