113例老年支原体肺炎的临床表现及影像学特点

Clinical manifestations and imaging features of 113 elderly patients with mycoplasma pneumonia

目的通过对老年支原体肺炎临床表现及影像学特点分析,为临床正确诊断提供理论依据。方法比较、分析113例老年支原体肺炎的临床症状、体征、实验室检查及影像学检查等情况。结果老年支原体肺炎患者以中低热为主(94.39%);除了具有明显的呼吸道症状、体征外,还常伴随有耳鼻喉、神经系统、循环系统及皮肤等并发症;49.56%的患者白细胞计数正常,87.61%的患者支原体IgM抗体值大于1∶160,所有患者支原体IgM抗体值均大于1∶80,15.04%患者的痰培养肺炎链球菌(+);肺部病变分布呈现出左肺下叶多见、双侧肺多叶多见的两多特征;斑片影、磨玻璃影、大片实变影、间质浸润性病变及胸腔积液分别占CT影像特征的87.61%、38.94%、18.58%、12.39%与11.50%。结论老年支原体肺炎临床表现缺乏特异性症状、体征和CT影像学特征;在临床实践中,要高度重视,一旦怀疑,则需积极开展支原体Ig M抗体检测,减少误诊和漏诊。

Objective To investigate the clinical manifestations and imaging features of elderly patients with mycoplasma pneumonia, in order to provide a theoretical basis for the correct clinical diagnosis. Methods The clinical symptoms of 113 elderly patients with mycoplasma pneumonia were analyzed. Results The main clinical symptom was low-grade fever （94. 39% ）. In addition to obvious respiratory symptoms and signs, they were often accompanied by ENT, nervous system, circulatory system and skin complications. 49.56% of the patients were with normal white blood cell count, the value of IgM antibody of 87. 61% patients was greater than 1 ： 160, and all patients＇mycoplasma IgM antibody value was greater than 1 ： 80. 15.04% of the patients were with streptococcus pneumoniae （ ＋ ）, and the distribution of pulmonary lesions showed multiple bilateral pulmonary leafy more at left lower lobe. The rate of patchy, ground glass, large opacities, interstitial infiltrates and pleural effusion in CT imaging features accounted for 87.61%, 38. 94%, 18. 58%, 12. 39% and 11.50%, respectively. Conclusion The clinical manifestation of senile mycoplasmal pneumonia is lack of specific symptoms, signs and CT imaging features. In clinical practice, it needs to pay more attention to actively carry out Mycoplasma IgM antibody detection, in order to reduce the misdiagnosis and missed diagnosis.