136例小儿支原体肺炎肺部影像学改变的临床分析

Clinical analysis of lung imaging changes of 136 children with Mycoplasmapneumonia

目的探讨小儿支原体肺炎的肺部影像学改变,为临床小儿支原体肺炎的诊断提供依据。方法选取2009年10月-2010年2月在医院就诊的136例支原体肺炎患儿及同期体检的100名健康儿童作为研究对象,136例支原体肺炎患儿设为患儿组,100名健康体检儿童设为健康组,所有入组患儿及健康儿童均行胸部正位X线检查,比较患儿组治疗前与健康组儿童的胸部正位片结果、患儿组治疗前及治疗后胸部正位片结果,总结支原体肺炎儿童的肺部影像学改变特点。结果支原体肺炎患儿的X线影像学较健康儿童有明显的特异性,肺部均出现阴影,78.7%的患儿表现为单侧下叶肺部阴影,45.6%患儿肺部纹理增多,根据病程的不同,阴影形状亦不同;健康组儿童肺部仅7.0%出现阴影,且都具有支原体肺炎史,患儿治疗前的肺部阴影发生率为100.0%,治疗后肺部阴影发生率为25.0%,治疗前后比较,差异有统计学意义(P<0.05)。结论小儿支原体肺炎早期临床症状较易和病毒性、细菌性肺炎混淆,但支原体肺炎患儿X线胸片显示,其肺部有明显的影像学特征,可作为诊断的重要证据之一。

OBJECTIVE To evaluate the lung imaging changes in children with Mycoplasma pneumonia so as to provide reference for the clinical diagnosis of Mycoplasma pneumonia in children.METHODS A total of 136 cases of pediatric Mycoplasma pneumonia from Oct 2009 to Feb 2010 and 100 healthy children examined in our hospital were chosen as the observation group and the control group.All enrolled children underwent anteroposterior chest X-ray film examination.The anteroposterior chest film results of two groups of patients before treatment were compared.The anteroposterior chest film results of the observation group of patients before and after treatment were compared.The changes in lung imaging features for Mycoplasma pneumonia in children were summarized.RESULTS The study showed that the X-ray imaging of children with mycoplasma pneumonia was significantly more specific than that of the healthy children.The lungs of children with mycoplasma pneumonia all had shadows.78.7% of the patients showed unilateral lower lobe lung shadows,the lung texture increased in 45.6% of the patients.The shadow shapes were different according to the duration.Only 7.0% healthy children showed lung shadows,and all those had a history of mycoplasma pneumonia.The incidence of lung shadows before treatment was 100.0% in patients,and 25.0% after treatment,the difference was significant（P0.05）.CONCLUSION Early clinical symptoms of mycoplasma pneumonia is not specific,but chest X-ray of children with Mycoplasma pneumonia shows clear imaging features and can be used as important evidence of the diagnosis.