肺炎支原体脑炎24例临床分析

Clinical analysis of 24 cases with mycoplasma pneumoniae(MP) encephalitis

目的探讨儿童肺炎支原体脑炎的临床特点。方法采用特异性免疫凝聚试验检测外周血清和/或脑脊液肺炎支原体IgM抗体阳性者24例,对其临床资料进行回顾性分析。结果肺炎支原体脑炎多发于学龄期儿童,临床表现为发热,头痛,呕吐,抽搐,性格改变,肌力下降,脑电图异常等。血清肺炎支原体-IgM抗体阳性23例,脑脊液阳性10例,两者均阳性9例;经治疗患儿痊愈出院,未发现后遗症。结论儿童肺炎支原体脑炎可以神经系统症状首发。若怀疑中枢神经系统感染,脑脊液改变类似病毒性脑炎改变时应考虑肺炎支原体脑炎可能,血清或脑脊液肺炎支原体IgM抗体检测可明确。

Objective To analyze the clinical characteristics of mycoplasma pneumoniae（MP） encephalitis in children.Methods The anti-MP IgM in serum and/or in cerebrospinal fluid（CSF） was detected with specific immune agglutination in 24 positive and the clinical data were analyzed retrospectively.Results The incidence of MP encephalitis was mainly in children of school age.The clinical manifestations included fever,headache,vomiting,convulsion,changed personality and electroencephalo-graph abnormalities.Anti-MP-IgM was positive in serum in 23 cases,which in CSF in 10 cases and in both serum and CSF in 9 cases.All patients were discharged without sequelae.Conclusion Neurological symptoms may be the first onset of MP encephalitis in children.If the changes of CSF of the patients suspected with encephalitis are similar to those of virus encephalitis,MP encephalitis should be considered and the diagnosis can be made by the test of MP-IgM in serum and/or in CSF.