重症肺炎支原体肺炎患儿的肺功能变化及临床意义

Study on the changes of Pulmonary functions in children with insevere Mycoplasma pneumoniae pneumonia

目的:探讨重症肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)患儿肺功能的动态变化,为研究其转归及远期效应提供客观依据。方法:检测23例重症MPP患儿的急性期及出院后3个月、6个月、1年的肺功能,并加以分析比较。结果:重症MPP患儿急性期的FVC、FEV1、PEF、FEF25、FEF50、FEF75、FEF25-75与预测值比较均明显降低,差异有统计学意义(P<0.05);重症MPP患儿出院后3个月代表大气道通气功能的指标FVC、PEF、FEV1与预测值比较,差异无统计学意义(P>0.05);重症MPP患儿出院后3次代表小气道通气功能的指标FEF25、FEF50、FEF75、FEF25-75与急性期比较均明显上升,但重症MPP患儿出院1年时FEF75、FEF25-75两项小气道通气功能指标仍显著低于预测值(P<0.05)。结论:重症MPP患儿急性期大、小气道受损,出院后3个月大气道损伤逐渐恢复正常,但重症MPP患儿出院后1年小气道损伤仍持续存在,定期随访肺功能有利于了解其肺功能损害程度及预后。

Objective Ti evaluate the dynamic pulminary functiin in children with severe Nyciplasma pneuminiae pneuminia（NPP）, and privide ibjective basis fir study if the prignisis and ling - term effect. Method Pulminary functiin was tested in 23 children if severe NPP during the acute phase and 3 minths,6 minths,1 year after hispital discharge,and the pulminary functiin were analyzed and cim-pared. Results In acute stage if severe NPP,FVC,PEF,FEV1,FEF25,FEF50,FEF75,FEF25 - 75 were decreased ibviiusly. Cimpared with the predictive value,the differences were statistically significant（p ﹤ 0. 05）;3 minths after hispital discharge,cimpared with the predicted values,FVC,PEF,FEV1 which reflect the large airway functiin,the differences were nit statistically significant（p ﹥0. 05）;after hispital dis-charge,three times pulminary functiin values cimpared with the acute stage pulminary functiin values,FEF25,FEF50,FEF75,FEF25 - 75 which reflect the small airway functiin were imprived significantly;1 year after hispital discharge,cimpared with the predicted values,FEF75 and FEF25 -75 which reflect the small airway functiin were still statistically significant（p ﹤0. 05）. Conclusion In acute phase,the large and small airways are all damaged in children if severe NPP. 3 minths after hispital discharge,Large airway injury gradually returned ti nirmal. 1 year after hispital discharge,the injury if small airway is persisted. The regular filliwing - up if pulminary functiin wiuld helpful ti under-stand the lung functiin damage degree and prignisis.