儿童嗜肺军团菌肺炎合并肺炎支原体感染的临床研究

Clinical research of legionella pneumophila pneumonia combined with mycoplasma pneumoniae infection in children

目的对儿童嗜肺军团菌(LP)肺炎合并肺炎支原体(MP)感染的临床特征进行研究总结,为临床防治积累资料。方法收集该院2010年1月至2012年6月收治的95例LP肺炎患儿的临床资料,其中有35例合并MP感染,对其临床特征进行回顾性对比分析。结果 LP与MP混合感染所致儿童肺炎多见于城镇学龄前期儿童。与LP肺炎组比较,混合感染组多表现为热峰高、热程长,出现肺部阳性体征、心率增快、颈淋巴结肿大和肝脏增大的发生例数显著增多,差异有统计学意义(P<0.05);辅助检查出现胸片大片斑片影及胸腔积液表现,出现白细胞(WBC)增高、C反应蛋白(CRP)增高、心电图阳性表现(心动过速/ST段和T波即ST-T改变)、肌酸激酶同工酶(CK-MB)增高、肝功异常的例数显著增多,差异有统计学意义(P<0.05);所需治疗时间显著延长,差异有统计学意义(P<0.05)。结论儿童LP肺炎合并MP感染可群体发病,常表现为肺部症状体征重、更易合并肺外多器官及多系统的损害。应积极开展大样本、多中心的研究以获得我国感染现状的可靠资料,从而为临床防治提供思路和对策。

Objective To summarize the clinical features of legionella pneumophila pneumonia （Lp） combined with mycoplasma pneumoniae （Mp） infection in children,and to accumulate materials for the clinical prevention and treatment. Methods Clinical data of 95 cases infected with legionella pneumophila pneumonia （in which 35 cases combined with Mp infection） in the Ninth People＇s Hospital of Chongqing from January 2010 to June 2012 were collected,and their clinical features were compared and analyzed. Re- sults Childhood pneumonia due to LP and MP mixed infection was more common in urban preschool children. Compared with the LP pneumonia group, most cases in mixed infection group had performance of high thermal peak and long thermal path. The cases of positive signs of lung,increased heart rate, enlargement of lymph nodes and liver were significantly increased（P〈0.05）. And with auxiliary examination, there were performance of large areas of plaques shadow and pleural effusion in Chest X-ray,WBC increase, CRP increase,positive ECG （tachycardia/ST-T changes）, CK-MB increase and cases with abnormal liver function significantly in- creased （P〈0.05）. And the required treatment time was significantly prolonged （P〈0.05）. Conclusion Children LP pneumonia combined with MP mixed infection can lead to population disease, which usually performs with serious pulmonary symptoms and signs, and is easily combined with damages of multiple extra-pulmonary organs and systems. It should be researched in large sample and multi-center study,in order to obtain reliable information on the infection status and thus provide ideas and measures for the clinical prevention and treatment.