86例支原体肺部感染患儿的临床研究

Clinical research of children with mycoplasma lung infection

目的探究儿童支原体肺炎（MPP）的临床表现、实验室检查及影像学特点。方法选择2012年7月至2014年12月入住本院儿科0-13岁肺炎患儿86例,按照肺炎支原体病理学检测结果分为观察组（MPP组）与对照组（非MPP组）,进行回顾性分析。结果观察组患儿发病病程及发热时间较长,均长于对照组,且差异具有统计学意义（t=2.216、P=0.038,t=1.969、P=0.049）;观察组患者在夜间咳嗽评分、发热及高烧等临床表现及实验室指标较高,且差异具有统计学意义（χ^2=2.214、P=0.024,χ^2=6.182、P=0.030,χ^2=4.001、P=0.047）。两组患者均伴有咳嗽症状,均有肺部异常X线特征。观察组患者出现喘息、大叶性肺炎、肺部湿啰音及胸腔积液等临床表现及实验室指标的比例高于对照组,差异具有统计学意义（χ^2=4.526、P=0.031,χ^2=6.874、P=0.014,χ^2=11.553、P=0.000,χ^2=5.287、P=0.009）,观察组患者肺外表现发生率高于对照组,差异具有统计学意义（χ^2=4.182、P=0.037）;尿检异常、胃肠表现及皮疹等症状与对照组差异均无统计学意义（χ^2=2.413、P=0.561,χ^2=1.649、P=0.672,χ^2=2.647、P=0.204）。结论 MPP患儿的咳嗽症状严重,呼吸系统病变突出,肺部体征轻微,症状治疗恢复用时长,同时对儿童肺炎应早诊断确定致病因,从而改善预后。

Objective To explore the clinical features, laboratory tests and imaging features of children with mycoplasma pneumonia（MPP）. Methods Total of 86 cases with pneumonia at 0-13 years old in our hospital were selected from July 2012 to December 2014. According to pathological examination results of Mycoplasma pneumoniae, the 86 cases were divided into observation group（MPP group） and control group（non-MPP group）, and the clinical data were analyzed, retrospectively. Results The disease duration and the period for fever of patients in observation group were significantly longer than those of control group（t = 2.216, P = 0.038; t = 1.969, P = 0.049）; The score at night cough, fever and high fever and other clinical manifestations and laboratory index of patients in observation group were significantly higher than that of control group（χ^2 = 2.214, P = 0.024; χ^2 = 6.182, P = 0.030; χ^2 = 4.001, P = 0.047）. All 86 patients were associated with symptoms of cough and abnormal X-ray characteristics of the lungs. The appear wheezing, lobar pneumonia, lung wet rales and pleural effusion, clinical manifestations and laboratory indexes of patients in observation group were significantly higher than those of control group（χ^2 = 4.526, P = 0.031; χ^2 = 6.874, P = 0.014; χ^2 = 11.553, P = 0.000; χ^2 = 5.287, P = 0.009）. The rate of pulmonary manifestations in observation group were significantly higher than that of control group（χ^2 = 4.182, P = 0.037）. For urinalysis abnormalities, gastrointestinal manifestations and rash and other symptoms, there were no significant differences between the two group（χ^2 = 2.413, P = 0.561; χ^2 = 1.649, P = 0.672; χ^2 = 264.7, P = 0.204）. Conclusions Children with MPP had severe cough symptoms and respiratory system disease, but mild pulmonary signs, long period for symptomatic treatment to restore, at the same time early diagnosis should be confirmed for children with penumonia determine the cause and to improve the prognosis.