天津地区2008～2009年肺炎支原体肺炎的临床特点及治疗

Clinical characteristics and treatment of Mycoplasma pneumoniae pneumonia in Tianjin from 2008 to 2009

目的:了解天津地区2008～2009年肺炎支原体(MP)肺炎的临床特征,总结治疗体会。方法:选择天津地区4 037例住院肺炎患儿,对患儿的发病季节、年龄、临床表现、肺外并发症进行统计。结果:4 037例中MP肺炎374例,发病率9.26%,5岁以上为主(67.38%),年长儿中,高热、干咳为主要临床表现,肺内炎性实变多见,且多合并病毒感染(39.57%)。1/4发生胸膜病变。肺外损害中,除皮疹、消化道症状,出现1例肾炎,最严重为3例噬血细胞淋巴细胞增殖综合征(HLH)。神经系统损害少见。结论:MP感染是社区获得性肺炎的主要致病原,除引起肺部病变,尚可引起肺外多脏器和组织的损害,应注意早期诊断和综合治疗。

Objective： To understand the clinical characteristics of Mycoplasma pneumoniae （MP） pneumonia in Tianjin from 2008 to 2009, summarize the treatment experience. Methods ： A total of 4 037 hospitalized children with MP pneumonia in Tianjin were selected, then the onset seasons, age, clinical manifestations, and extrapulmonary complications were analyzed statistically. Results： Among 4 037 children with pneumonia, 374 children were found with MP pneumonia, the incidence was 9.26% , 67.38% of the children was more than five years ; among the older children, hyperpyrexia and dry cough were the main clinical manifestations, pulmonary inflammatory solid lesions were common, and 39. 57% of them were combined with viral infection. Pleural lesions occurred in 1/4 of the children. Among extrapulmo- Mary lesions, except rash and digestive symptoms, nephritis occurred in one child, the most worst lesions was hemophagocytic lymphohistio- cytosis （HLH）, which occurred in three children. Nervous system damage was not common. Conclusion： MP infection was the major pathogen of community acquired pneumonia, except pulmonary lesions, which can induce extrapulmonary multiple organ dysfunction, early diagnosis and treatment are important.