不同年龄儿童肺炎支原体肺炎临床特征分析

Clinical characteristics of mycoplasma pneumoniae pneumonia in children of different ages

目的探讨不同年龄肺炎支原体肺炎患儿的临床表现、影像学特征及实验室资料改变。方法回顾分析我院2012年1月。2013年7月确诊肺炎支原体肺炎患儿147例，按年龄分1月一3岁组45例，〉3岁组102例。对其临床表现、实验室检查、影像表现、治疗转归进行分析。结果1月-3岁组呼吸道症状明显，咳嗽、喘息症状均较严重，部分出现呼吸功能不全，发热不严重，影像以小叶实质浸润及间质病变为主，实验室资料淋巴细胞比例相对偏高。〉3岁组发热、干咳明显，但少见呼吸功能不全，影像表现以肺段或肺叶实质病变更明显，CRP明显升高。1月～3岁组应用肾上腺皮质激素治疗8例（17．7％），〉3岁组应用肾上腺皮质激素治疗34例（33．3％），差异有统计学意义（P〈0．05），预后均较好。结论不同年龄儿童肺炎支原体肺炎临床特征不同，可能与不同的发病机制有关。

Objective To discuss mycoplasma pneumoniae pneumonia （MPP} in children of different ages with clinical manifestations, imaging features and change of laboratory data. Methods Retrospective analysis on 147 cases of MPP in children at age from 1 month to 14 years old in our hospital from January 2012 to July 2013. Of all children with MPP there were 45 cases aged from 1 month to 3 years old and 102 cases above 3 years old. The clinical manifestation, laboratory examination, imaging manifestations and outcome were analyzed. Results 1 month- 3 years old group has obvious respiratory symptoms, cough and wheezing are severe, some appeared res- piratory insufficiency, but fever is not serious, the image is given priority to with lobular parenchymal infiltration and interstitial lesions, laboratory data lymphocyte percentage is relatively high. Above 3 years old group has high fever, dry cough, but rare respiratory insufficiency, pulmonary segments or lung parenchyma lesions imaging per- formance more obvious. CRP is higher significantly. Two groups have significant differences in application rate of adrenal cortical hormone. The prognosis of all is good. Conclusion Clinical features in MPP children of different age is different, may be associated with the different pathogenesis.