小儿肺炎支原体肺炎临床特征及病情程度的相关因素

Clinical characteristics and factors related to the severity of symptoms of children with mycoplasma pneumonia

目的探讨小儿肺炎支原体肺炎临床特征、影响病情程度的因素,为小儿肺炎支原体肺炎临床早期诊断和病情程度评估提供依据。方法收集2016年3月~2018年3月医院儿科收治的156例肺炎支原体肺炎患儿的临床资料,记录患儿性别、年龄、临床特征、感染疾病类型、影像学表现、实验室检查等,根据小儿肺炎支原体肺炎重症标准和患儿病情程度分为小儿肺炎支原体肺炎重症组(62例)和小儿肺炎支原体肺炎轻症组(94例),对结果进行相关分析。结果 156例支原体肺炎患儿中,年龄最小2月,最大14岁;142例发热患儿中,以不规则热或弛张热为主,其中以高热或超高热常见,103例患儿热程为1~7 d,39例患儿热程为8~14 d;咳嗽106例,多为阵咳及干咳;98例患儿查体闻及细湿啰音;148例患儿胸片检查示胸部有炎症表现。实验室检查情况比较,重症组患儿与轻症组在红细胞沉降率、白细胞介素6、C反应蛋白、降钙素原的差异具有统计学意义(P<0.05)。红细胞沉降率、白细胞介素6、C反应蛋白、降钙素原是小儿支原体肺炎病情加重的独立危险因素。结论小儿支原体肺炎以发热、咳嗽为主要临床表现,存在过度炎症反应,红细胞沉降率、白细胞介素6、C反应蛋白及降钙素原的升高程度是疾病加重的危险因素,可为临床预防及治疗提供参考。

Objective To investigate the clinical features of mycoplasma pneumonia in children and to analyze factors that affect the severity of the disease, so as to provide the basis for the early diagnosis and evaluation of mycoplasma pneumonia.Methods The clinical data of 156 children with mycoplasma pneumonia admitted to our hospital from March 2014 to March 2016 were included. According to the severity of mycoplasma pneumonia in children, these cases were divided into severe group（n=62） and mild group（n=94）. Relevant analysis of these data was performed. Results Of the 156 cases with mycoplasma pneumonia, the youngest was 2 months old and the eldest was 14 years old; among 142 cases with fever, the main symptoms were irregular heat and remittent fever, among which high fever and over-high fever were most common. The course of fever of 103 cases was 1 to 7 days, and that of 39 cases was 8 to 14 days; there were 106 cases with cough, mostly paroxysmal cough and dry cough, 98 cases with fine rales, and the chest X-ray findings of 148 cases showed chest inflammation. Significant differences in ESR, IL-6, CRP and PCT were found between severe group and mild group（P〈0.05）.ESR, IL-6, CRP and PCT were all independent risk factors for the exacerbation of mycoplasma pneumonia in children.Conclusions The main manifestations of mycoplasma pneumonia in children are fever and cough, and excessive inflammation might occur. The increase of ESR, IL-6, CRP and PCT are all risk factors for the exacerbation of mycoplasma pneumonia, thus able to be used for clinical prevention and treatment.