难治性肺炎支原体肺炎患儿肺功能与胸部CT改变相关性分析

Correlation between pulmonary ventilation function and chest CT changes in children with refractory Mycoplasma pneumoniae pneumonia

目的研究难治性肺炎支原体肺炎(RMPP)患儿肺通气功能严重程度与肺部CT改变类型的相关性。方法回顾性分析潍坊人民医院儿科2014年10月至2016年1月收治的RMPP患儿116例,根据胸部CT表现分为磨玻璃样改变组、肺实变组、斑片影改变组,比较组间肺通气功能指标差异及其与肺叶累及数目的关系。结果 3组患儿最高呼气流速(PEF)均<80%。磨玻璃样改变组和肺实变组用力肺活量(FVC)、第1秒用力呼气容积(FEV1)实测值/预测值均低于正常范围;斑片影改变组FVC、FEV1等实测值/预测值均属正常范围,差异有统计学意义(P<0.05)。结论胸部CT显示磨玻璃样改变的RMPP患儿多存在肺通气功能障碍,炎症累及肺叶越多,通气功能越差;胸部CT显示肺实变者多存在大小气道阻塞性通气功能障碍,且以中度阻塞为主;而斑片影改变者仅存在轻度大气道阻塞性通气功能障碍,随炎症累及肺叶增多,肺活量降低,但尚在正常范围。

Objective To study the correlation between pulmonary ventilation function and chest CT changes in children with refractory Mycoplasma pneumoniae pneumonia（RMPP）. Methods The clinical data of children with refractory Myeoplasma pneumoniae pneumonia who were diagnosed and treated in our hospital from October 2014 to January 2016 were retrospectively analyzed. A total of 116 cases were divided into three groups according to the chest CT signs of children： grinding glass sample change group, consolidation change group and patch shadow change group. Lung function parameters were compared among the groups. Results Comparison among the three groups showed that PEF of three groups was lower than 80% ;in the grinding glass sample change group and consolidation change group, FEV1 and MMEF 25-75 were both below the normal, and in patch sample change group, FVC, FEV1 and MMEF 25-75 were all in the normal range, the differences being statistically significant （P 〈 0.05 ）. Conclusion The children whose chest CT shows grinding glass sample change have pulmonary ventilation dysfunction, and the more the lung lobe with inflammation, the worse the lung ventilation function. The children whose chest CT shows consolidation change have airway obstructive ventilation dysfunction, with moderate obstruction as the main one. The children whose chest CT shows patch shadow change have mild obstructive ventilation dysfunction, and the more lung lobe with inflammation, the lower the lung capacity, but the lung capacity is still in the normal range.