儿童肺炎支原体肺炎的流行特征及临床分析

Clinical and epidemiological characteristics of Mycoplasma pneumoniae pneumonia in children

目的:了解肺炎支原体肺炎(MPP)患儿的流行特征及临床特点。方法:对2013年12月至2014年11月在我院住院诊断为社区获得性肺炎(CAP)的371例患儿,行乳胶被动凝集法测定血清肺炎支原体(MP)特异性抗体Ig M,其中179例诊断为MPP。分析MPP好发季节及年龄段,并研究不同年龄段MPP的临床特征及治疗。结果:(1)我院CAP患儿在学龄期儿童中MP感染率最高(81.08%),婴儿期患儿感染率最低(12.73%),4组MP感染率差异具有统计学意义(P<0.001)。(2)我院CAP患儿在夏季及秋季MP-Ig M检出阳性率分别为60%、54.72%,明显高于冬春季(均P<0.05)。(3)179例MPP患儿中,婴儿组患儿表现为喘息症状发生率为71.43%,明显高于学龄前期及学龄期患儿(均P<0.05)。学龄期患儿表现为喘息症状发生率为15%,明显低于其他年龄组患儿(P<0.05)。学龄期患儿激素使用率为30%,明显高于幼儿期及学龄前期患儿(均P<0.05)。(4)婴幼儿组患儿血常规中白细胞计数较学龄前期及学龄期患儿高(均P<0.05),学龄前期及学龄期患儿血常规中性粒细胞百分比较婴幼儿组高(均P<0.05),但仍处于正常范围值内,各年龄组C反应蛋白差异无统计学意义(P>0.05)。结论:肺炎支原体肺炎在夏秋季多见,学龄期儿童发生率较高,且学龄期患儿激素使用率相对较高,可能与不同年龄段患儿的免疫状态有关。

Objective： To investigate the clinical and epidemiological characteristics of Mycoplasma pneumoniae pneumonia（ MPP） in children. Methods： The serum level of Mycoplasma pneumoniae（ MP） antibody Ig M（ MPIg M） was measured by latex passive agglutination test for 371 community acquired pneumonia children admitted in hospital from December 2013 to November 2014,among whom 179 children were diagnosed as MPP. Retrospective analysis was performed to find out the main occurrence season and age of MP infection and compare the clinical features and treatment among different age groups. Results：（ 1） The MP infection rate was the highest in schoolage group and the lowest in infant group which had great difference from other age groups（ P〈0. 001）.（ 2） The positive detection rate of MP-Ig M was 60% in summer and 54. 72% in autumn,which was higher than that in winter and spring（ P〈0. 05）.（ 3） Among 179 MPP children,infant group presented mainly with wheezing,and the occurrence rate was 71. 43%,which was higher than that in any other age group（ P〈0. 05）. The occurrence rate of wheezing in school-aged children was 15% and was the lowest（ P〈0. 05）. The steroid therapy was mainly used in school-aged children,and the usage rate was 30% among school-aged group,which was higher than toddler＇s and preschool-aged group（ P〈0. 05）.（ 4） The infant and toddler＇s group had a higher white blood cell count than the preschool-aged and school-aged group（ P〈0. 05）. The neutrophil ratio in preschool-aged and school-aged group was higher than that in the infant and toddler＇s group（ P〈0. 05）,but it was still in normal range. There was no difference of serum C-reactive protein among different age groups（ P〉0. 05）. Conclusion：MPP has a higher incidence in summer and autumnand occurs mostly in school-aged children. The steroid therapy is mainly conducted in school-aged children,which might be related to various immune status of children of different ages.