过敏体质儿童肺炎支原体肺炎的临床特点分析

Analysis on clinical characteristics of Mycoplasma pneumoniae pneumonia in children with allergic constitution

目的分析过敏性体质儿童肺炎支原体肺炎(MPP)的临床特点,为临床诊治及预防提供依据。方法选取2015年9月-2016年8月苏州大学附属儿童医院住院的MPP患儿600例,过敏性体质组和非过敏体质组各300例,收集患儿临床资料和实验室检查数据并加以分析。结果 MPP患儿非过敏体质重症肺炎的发生为28例,过敏体质重症肺炎的发生为30例,两者差异无统计学意义(P>0.05),性别分布差异亦无统计学意义(P>0.05)。MPP患儿非过敏体质组发热时间中位数4 d高于过敏体质组的3 d,非过敏体质组影像学表现为大叶性肺炎的比例31.00%高于过敏体质组的20.33%,过敏体质组比非过敏体质组容易出现喘息症状(48.67%对31.67%),上述三者差异均有统计学意义(P<0.05)。MPP患儿非过敏体质组CD3-CD(16+56)比例高于过敏体质组,差异有统计学意义(P<0.05)。其他临床征象及实验室检查差异无统计学意义(P>0.05)。结论MPP患儿过敏体质组和非过敏体质组具有各自的临床和实验室检查特征,过敏性体质MP感染后更易发生喘息及免疫紊乱。

Objective To analyze the clinical characteristics of Mycoplasma pneumoniae pneumonia（ MPP） in children with allergic constitution,provide a basis for clinical diagnosis,treatment,and prevention. Methods A total of 600 hospitalized children with MPP were selected from Children＇s Hospital Affiliated to Soochow University from September 2015 to August 2016,then they were divided into allergic constitution group and non-allergic constitution group,300 children in each group. The clinical data and laboratory findings were collected and analyzed. Results In non-allergic constitution group and allergic constitution group,28 children and 30 children were diagnosed as severe MPP,respectively,there was no statistically significant difference between the two groups（ P〉0. 05）,and there was no statistically significant difference between boys and girls（ P〉0. 05）. The median time of fever in non-allergic constitution group was four days,which was statistically significantly longer than that in allergic constitution group（ three days）（ P〈0. 05）. The proportion of children with lobar pneumonia imaging findings in non-allergic constitution group was 31. 00%,which was statistically significantly higher than that in allergic constitution group（ 20. 33%）（ P〈0. 05）. The incidence rate of wheezing in allergic constitution group was 48. 67%,which was statistically significantly higher than that in non-allergic constitution group（ 31. 67%）（ P〈0. 05）. The proportion of children with CD3-CD（ 16＋56）in non-allergic constitution group was statistically significantly higher than that in allergic constitution group（ P〈0. 05）,there was no statistically significant difference in other clinical signs and laboratory findings between the two groups（ P〉0. 05）. Conclusion The children with allergic constitution and without allergic constitution have respective clinical characteristics and laboratory findings. The children with allergic constitution are more likely to have wheezing and immune disorder when they are infected by MP.