2岁以下儿童支原体肺炎临床特征分析

Clinical characteristics of mycoplasma pneumoniae pneumonia in children under two years old

目的总结2岁以下儿童支原体肺炎(MP)的临床特征。方法选择2014年1月至2015年12月黄冈市中心医院收治的MP患儿238例,根据患儿年龄分为<2岁组(n=63)和≥2岁组(n=175),对2组患儿的临床特征进行比较。结果 <2岁组患儿发热比例和体温峰值显著低于≥2岁组(P<0.05),热程显著短于≥2岁组(P<0.05);<2岁组患儿咳痰、喘息及肺部湿啰音发生率显著高于≥2岁组(P<0.05)。<2岁组患儿肺部X线片表现为小叶实质浸润的比例显著高于≥2岁组,肺段实质浸润的比例显著低于≥2岁组(P<0.05);2组患儿肺部X线片表现为血管周围间质浸润的比例差异无统计学意义(P>0.05)。<2岁组患儿白细胞计数、淋巴细胞水平显著高于≥2岁组(P<0.05),中性粒细胞及C反应蛋白水平显著低于≥2岁组(P<0.05)。结论 2岁以下MP患儿常表现为咳嗽伴喘息,多有肺部湿啰音,但发热不明显,且免疫反应较轻,肺部X线片表现以小叶实质浸润为主,应结合临床症状、肺部体征及实验室检查明确诊断。

Objective To summarize the clinical characteristics of mycoplasma pneumonia （MP） in children under two years old.Methods A total of 238 children with MP were selected from January 2014 to December 2015 in Huanggang Central Hospital.The children were divided into 〈2 years old group （n =63） and ≥2 years old group （n =175） according to the age of the children.The clinical characteristics of the children were compared between the two groups.Results The ratio of fever and the peak temperature in 〈 2 years old group were significantly lower than those in ≥2 years old group（P 〈 0.05）,and the duration of fever in 〈 2 years old group was significantly shorter than that in ≥2 years old group（P 〈 0.05）.The incidences of expectoration,gasping and pulmonary moist rales in 〈 2 years old group were significantly higher than those in ≥2 years old group （P 〈 0.05）.The ratio of pulmonary lobular parenchymal infiltration in X-ray manifestations in 〈 2 years old group was significantly higher than that in ≥2 years old group（P 〈 0.05）,and the ratio of lung parenchymal infiltration in 〈 2 years old group was significantly lower than that in ≥2 years old group（P 〈 0.05）.There was no significant difference in the ratio of perivascular pulmonary interstitial infiltration between the two groups （P 〉 0.05）.The white blood cell count and lymphocyte level in 〈2 years old group were significantly higher than those in ≥2 years old group（P 〈0.05）,and the levels of C-reactive protein and neutrophilic granulocyte in 〈 2 years old group were significantly lower than those in ≥2 years old group（P 〈 0.05）.Conclusions The clinical manifestation of MP children under two years old including cough with wheezing,pulmonary moist rales,less obvious fever,mild immune response,and the lobular parenchyma infiltration in pulmonary Xray manifestations.The diagnosis should be combined with clinical symptoms,pulmonary signs and laboratory examination.