小儿肺炎支原体合并嗜肺军团菌感染53例临床分析

53 children infected by mycoplasma pneumoniae and legionella pneumophila

目的对53例肺炎支原体（MP）合并嗜肺军团菌（LP）感染患儿进行临床分析。方法对2015年6月至2016年6月本院收治的MP肺炎患儿采用VIRCELL，S．L．公司提供间接免疫荧光法检测血LP—IgM，将患儿分为MP感染组（62例）及MP合并LP感染组（53例），对比两组临床表现（发热、咳嗽）、肺部体征、肺外并发症（肝损害、心肌损害）、住院时间、肺部x线（支气管炎／支气管肺炎）方面差异，并用SPSS17．0软件进行统计分析。结果MP感染组中，发热47例、平均持续时间（4．36±1．31）d，咳嗽43例、平均持续时间（5．39±1．72）d，肺部哕音25例、平均持续时间（4．24±1．23）d，肝损害6．45％，心肌损害14．51％，肺部x线阳性62．9％，平均住院天数（5．72±1．39）d；MP合并LP感染组中，发热49例、平均持续时间（7．45±2．61）d，咳嗽51例、平均持续时间（9．80±3．53）d，肺部啰音42例、平均持续时间（9．48±2．65）d，肝损害20．75％，心肌损害39．62％，肺部x线阳性83．02％，平均住院天数（8．45±3．16）d；两组在性别、年龄上差异均无统计学意义，MP合并LP感染热程、咳嗽、哕音持续时间、肺外并发症、住院时间均高于MP组，差异均有统计学意义。结论MP合并LP感染常表现热程、咳嗽、肺部啰音持续时间长，住院时间长，临床症状体征重，易至多脏器损害的肺外合并症。

Objective To clinically analyze 53 children infected by mycoplasma pneumoniae （ MP ） and legionella pneumophila （ LP ） . Methods The children with mycoplasma pneumonia treated at our hospital from June, 2015 to June, 2016 were detected blood LP-IgM with indirect immunofluorescence method provided by VIRCELL, S.L. The patients were divided into an MP group （ 62 cases ） and an MP and LP group （ 53 cases ） . The clinical manifestations （ fever and cough ） , pulmonary signs, non-pulmonary complications （ liver damage and myocardial damage ） , hospital stay, and lung X-ray （ bronchitis / bronchopneumonia ） were compared between these two groups and were statistically analyzed by SPSS 17. Results 47 cases had fever for （4.36±1.31） days, 43 had cough for （5.39±1.72） days, 25 had pulmonary rales for （4.24±1.23） days, 6.45% cases had liver damage, 14.51% had myocardial damage, 62.9% was positive in lung X-ray, and the average hospital stay was （5.72±1.39） days in the MP group; 49 cases had fever for （7.45±2.61） days, 51 had cough for （9.80±3.53） days, 42 had pulmonary rales for （9.48±2.65） days, 20.75% cases had liver damage, 39.62% had myocardial damage, 83.02% was positive in lung X-ray, and the average hospital stay was （8.45±3.16） days in the MP and LP group; there were no statistical differences in gender and age between these two groups; the durations of fever, cough, and rales and hospital stay were longer and the incidence of non-pulmonary complicationswas higher in the MP and LP group than in the MP group, with statistical differences （ P 〈 0.05 ） .Conclusions MP combined LP infection often shows long duration of fever, cough, and pulmonary rales, long hospital stay, severe clinical symptoms and signs, and a high incidence of non-pulmonary complications.