15例儿童难治性支原体肺炎的临床特征

Clinical characteristics of 15 children with Refractory Mycoplasma Pneumonia

目的探讨15例儿童难治性支原体肺炎的临床特征,与50例儿童普通肺炎支原体肺炎的临床特征进行对比分析,以提高对儿童难治性支原体肺炎的认识。方法回顾性分析2016年9月至2017年6月在南京医科大学附属无锡第二人民医院儿科住院的15例难治性支原体肺炎和50例儿童普通肺炎支原体肺炎患儿的临床资料,对临床表现、实验室检查、肺内外并发症、影像学资料及治疗进行对比、分析。结果难治性肺炎支原体肺炎患儿与普通肺炎支原体肺炎患儿在发热时间、血C反应蛋白(CRP)、红细胞沉降率(ESR)、乳酸脱氢酶(LDH)、D-二聚体、影像学表现及药物治疗等多个方面比较差异均有统计学意义(P均<0.05);但2组在年龄、性别上比较差异均无统计学意义(P均>0.05)。结论儿童难治性支原体肺炎具有热程长、病情重,肺内外并发症多,CRP、ESR、LDH、D-二聚体等指标增高明显,大环内酯类抗生素治疗耐药等特点,需早期联合糖皮质激素。

Objective：To explore the clinical characteristics of 15 children with refractory mycoplasma pneumonia,and compare the clinical characteristics of 50 children with common mycoplasma pneumoniae pneumonia,in order to improve the understanding of children with refractory mycoplasma pneumonia. Methods：A retrospective study of children with MPP was performed in 15 severe eases（severe group）and 50 mild cases（control group）in the department of pediatrics of Wuxi second people＇s hospital affiliated to Nanjing medical university from September 2016 to June 2017. The univariate comparisons of the 2 groups including the clinical manifestations,laboratory tests,intra-pulmonary and extra-pulmonary complications,imaging data and treatment. Results：There were significant differences in fever time,c-reactive protein（CRP）,erythrocyte sedimentation rate（ESR）,lactate dehydrogenase（LDH）,d-dimer,imaging performance and drug treatment between children with refractory mycoplasma pneumoniae pneumonia and children with common mycoplasma pneumoniae pneumonia（P〈0.05）. However,there was no significant difference in age and sex between the two groups（P〉0.05）. Conclusion：Childrenwith refractory mycoplasma pneumonia has the characteristics of long heat stroke,severe illness,many complications inside and outside the lung,obvious increases in CRP,ESR,LDH,D-dimer and other indicators,and the treatment of macrolide antibiotics is resistant to drugs. it is necessary to combine glucocorticoids early to improve the cure rate.