新生儿肺炎支原体肺炎和沙眼衣原体肺炎临床对照研究

Clinical analysis of neonatal Mycoplasma pneumoniae pneumonia and Chlamydia trachomatis pneumonia

目的探讨新生儿肺炎支原体肺炎(MPP)、新生儿沙眼衣原体肺炎(CTP)的临床特点。方法回顾分析2013年1月至2016年12月确诊MPP、CTP新生儿的临床资料,按匹配标准选取其他感染性肺炎的新生儿分别作为MPP对照组、CTP对照组,对各组患儿的临床资料进行比较分析。结果 MPP组44例,CTP组30例,相应的MPP对照组88例,CTP对照组60例。44例MPP组中,有呼吸道感染接触史17例(38.6%)、咳嗽44例(100.0%)、发热16例(36.4%)、腹泻16例(36.4%),Ⅰ型呼吸衰竭10例(22.7%)、Ⅱ型呼吸衰竭9例(20.5%)、节段性实变4例(9.1%)、间质改变5例(11.4%),发生率均高于其阴性对照组,差异有统计学意义(P<0.05)。30例CTP组中,阴道分娩26例(86.7%)、胎膜早破11例(36.7%)、发绀28例(93.3%)、腹泻13例(43.3%)、眼部分泌物11例(36.7%),发生率均高于其阴性对照组,差异有统计学意义(P<0.05)。CTP组阴道分娩比例高于MPP组;与呼吸道感染患者接触的比例低于MPP组,差异均有统计学意义(P<0.05)。MPP组比CTP组更易出现发热、咳嗽、气促、肺部中细湿啰音,CTP组比MPP组更易出现发绀、眼部分泌物,差异均有统计学意义(P<0.05)。MPP组及CTP组均使用大环内酯类抗生素治疗,均病情好转出院,无死亡病例。结论新生儿MPP更易出现发热、咳嗽、气促、肺部中细湿啰音的表现,新生儿CTP更易出现发绀、眼部分泌物,均可使用大环内酯类抗生素,预后良好。

Objective To explore the clinical characteristics of neonatal Mycoplasma pneumoniae pneumonia（MPP） and Chlamydia trachomatis pneumonia（CTP）. Method The clinical data of neonatal MPP and CTP which diagnosis was confirmed from January 2013 to December 2016 were analyzed, and the newborns with other infectious pneumonia were selected as controls of MPP group and CTP group respectively according to the matching standard. Results There were 44 cases in MPP group, 30 cases in CTP group, 88 cases in MPP control group and 60 cases in CTP control group. In 44 cases of MPP group, 17 cases had the history of contact with respiratory infection patients（38.6%）, 44 cases had cough（100.0%）, 16 cases had fever（36.4%）, 16 cases had diarrhea（36.4%）, 10 cases had respiratory failure（22.7%）, 9 cases had type II respiratory failure（20.5%）, 4 cases had segmental consolidation（9.1%） and 5 cases had interstitial change（11.4%）. The incidence rates above were higher than those in its control group, and the differences were statistically significant（P〈0.05）. In the 30 cases of CTP group, 26 cases were vaginal delivery（86.7%）, 11 cases had premature rupture of membranes（36.7%）, 28 cases had cyanosis（93.3%）, 13 cases had diarrhea（43.3%）, and 11 cases had eye secretion（36.7%）. The incidence rates above were higher than those in the control group, and there were statistical differences（P〈0.05）. The proportion of vaginal delivery in CTP group was higher than that in MPP group, and the proportion of patients with the history of contact with respiratory tract infection patients was lower than that in MPP group, and there were statistical differences（P〈0.05）. Fever, cough, anhelation and fine wet rales were more common in MPP group than those in CTP group, and cyanosis and eye secretion were more common in CTP group than those in MPP group, and there were statistical differences（P〈0.05）. Patients in MPP group and CTP group were treated with macrolide antibiotics, and all of them were improved and discharged without any death. Conclusion Neonatal MPP is more susceptible to fever, cough, anhelation and fine wet rale in the lungs. The neonatal CTP is more likely to have cyanosis and eye secretions. Macrolide antibiotics can be used in both of them, and the prognosis is good.