小儿支原体肺炎236例临床研究

Study on 236 Cases of Children with Mycoplasma Pneumonia

目的探讨小儿支原体肺炎（MPP）的临床特点及治疗方法。方法对236例确诊为MPP患儿的临床特点进行分析。结果患儿以1~3岁的婴幼儿为主。发热148例（62.7%）,持续性咳嗽113例（47.9%）。多数肺部可闻及湿啰音,两肺呈斑片状阴影114例（48.3%）,呈间质性损害31例（27.2%）,大片状阴影21例（18.4%）。多数患儿（68.5%）外周血白细胞总数正常。肺外并发症主要是消化系统、心血管系统、皮肤、黏膜、中枢神经系统和泌尿系统损害。血清肺炎支原体特异性IgM抗体（MP-IgM）均阳性。所有病例用阿奇霉素治疗2~3周均治愈。结论儿童MPP好发于婴幼儿,肺外并发症可累及多个系统,血清学MP-IgM检测是早期诊断的特异指标。阿奇霉素疗效肯定。

ObjectiveTo study the clinical characteristics and the treatment of children with mycoplasma pneumonia（MPP）.MethodsThe clinical data of 236 cases of children with MPP were analyzed retrospectively.ResultsThe majority cases were ages 1 to 3 years.There were 148 cases of fever（62.7%）,113 cases of persistent cough（47.9%）.There were moist rales heard over the lungs in most cases.Chest radiography showed mottles in 114 cases（48.3%）,interstitial lung lesions in 31 cases（27.2%）,and large plaque-like shadows in 21 cases（18.4%）.The majority cases had normal total WBC count（68.5%）.The extrapulmonary complications occurred mainly in digestive system,circulation system,mucocutaneous system,central nervous system,and urinary system.All the cases showed a positive serum mycoplasma pneumoniae IgM（MP-IgM）.All the patieuts were cured after being treated with Azithromycin for 2-3 weeks.ConclusionThe majority of children with MPP are 1 to 3 years old.The extrapulmonary complications can occur in multiple systems.The test of serum MP-IgM should be conducted for early diagnosis.Azithromycin is an effective agent to treat MPP.