5岁以下川崎病合并肺炎支原体感染患儿临床特征分析

Analysis of Kawasaki Disease Complicated with Mycoplasma Pneumoniae Infection in Children under the Age of Five

目的:探讨5岁以下川崎病(KD)合并肺炎支原体(MP)感染患儿的临床特征,以提高临床医师对该病的认识和诊治水平。方法:选取于2013年12月至2016年4月在我院住院的合并MP感染的25例KD患儿为观察组,无MP感染的167例KD患儿为对照组,比较两组患儿治疗前、治疗1周后的实验室检测指标,包括白细胞计数(WBC)、血小板计数(PLT)、红细胞沉降率(ESR)、C反应蛋白(CRP)水平、降钙素原(PCT)水平,并比较两组辅助检查及转归。结果:观察组发热天数、杨梅舌比例高于对照组。治疗前观察组WBC、CRP、ESR、PCT水平均高于对照组,PLT水平低于对照组;治疗后两组患儿WBC、CRP、ESR、PCT均降低,PLT均增高;观察组肺部X线和(或)CT、心电图、心脏彩超异常率均高于对照组。所有患儿预后均良好,未见复发患儿。结论:MP感染导致免疫功能紊乱可能与KD的发生有关。在5岁以下KD患儿中,应重视排除是否存在MP感染,以便早期使用大环内酯类抗菌药物根除MP,减少并发症。

Objective： To study the clinical characteristics of Kawasaki disease（KD） complicating with Mycoplasma pneumoniae（MP） infection in children under the age of five. Methods： Children with KD and MP infection were selected as observation group（n= 25 cases）,and children with KD only were selected as control group（n= 167 cases）. Laboratory test indexes before treatment and1 week after treatment were compared,including white blood cell（WBC） and platelet（PLT） count,erythrocyte sedimentation rate（ESR）,C reactive protein（CRP） and procalcitonin（PCT） levels,the auxiliary examination and outcome were compared between two groups. Results： Fever days and proportion of strawberry-like tongue in observation group were both higher than those in control group.Before treatment,WBC count,ESR,CRP and PCT levels in observation group were all higher and PLT count was lower than those in control group. After treatment,WBC count,ESR,CRP and PCT levels in two groups were all decreased,and PLT count was increased.Abnormalities proportion of chest X-ray and（or） CT,electrocardiogram,cardiac ultrasound in observation group were all higher than those in control group. All the children had good prognosis,and without KD＇s recurrence. Conclusion： MP infection causing immune dysfunction may be associated with the occurrence of KD. In children under the age of five with KD,we should pay attention to rule out the existence of MP infection,in order to use macrolide antibiotics early to eradicate MP,thus reduce the complications.