不同年龄阶段儿童的难治性肺炎支原体肺炎临床特点

Clinical characteristics of refractory mycoplasma pneumoniae pneumonia in children of different ages

目的探讨不同年龄阶段儿童的难治性肺炎支原体肺炎临床特点。方法收集92例RMPP患儿临床病例资料,按照年龄分组,分为1岁以下组(19例)、1~5岁组(36例)和5岁以上组(37例)。分析比较各组间的临床表现、实验室检查结果、胸部影像学结果及纤维支气管镜下改变。结果相比于1~5岁组和5岁以上组,1岁以下组患儿更多的表现为喘息及气促、三凹征。胸痛、皮疹及肺部细湿啰音,三组间差异无统计学意义。1~5岁组和5岁以上组N%、CRP均高于1岁以下组,5岁以上组PCT高于1岁以下组和1~5岁组,三组LDH差异无统计学意义。5岁以上组胸部影像学上表现为节段性或大叶性肺炎、肺不张均多于1岁以下组,1岁以下组则更多的表现为支气管肺炎。间质性肺炎表现及合并胸腔积液三组间差异无统计学意义。5岁以上组纤维支气管镜下粘液栓表现多于1岁以下组和1~5岁组。结论不同年龄阶段的SMPP患儿在临床症状体征、实验室检查、胸部影像学检查及纤维支气管镜下改变均存在一定差异。

Objective To investigate the clinical characteristics of refractory mycoplasma pneumoniae pneumonia(RMPP)in children of different ages.Methods Clinical data of 92 RMPP children were collected and divided into three groups according to age:the group A under 1 year old(19 cases),the group B of 1~5 years old(36 cases)and the group C over 5 years old(37 cases).The clinical manifestations,laboratory examination results,chest imaging results and fiberoptic bronchoscopy changes among the groups were analyzed and compared.Results The group A showed more wheezing in both lung,shortness of breath and three depressions sign than the group B and the group C.There was no statistically significant difference among the three groups in chest pain,skin rash and fine moist rales in the lungs. WBC was higher in the group A than in the group B and the group C, but N% and CRP were significantly higher in the group B and the group C than in the group A. PCT was higher in the group C than in the group A and the group B. There was no statistical difference in LDH among the three groups. The chest imaging manifestations of segmental or lobar pneumonia, atelectasis in the group C were more than those in the group A, and the manifestations of bronchopneumonia in the group A were more than those in the group B and the group C. There was no statistical difference in interstitial pneumonia and pleural effusion among the three groups. The results of mucus suppository under fiberoptic bronchoscopy in the group C was higher than the group A and the group B. Conclusion SMPP children of different ages have certain differences in clinical symptoms and signs, laboratory examination, chest imaging examination and fiberoptic bronchoscopy changes.