温州地区儿童肺炎支原体感染合并肝损害的研究

Mycoplasma pneumoniae infection with liver damage in children from Wenzhou area

目的探讨温州地区儿童肺炎支原体(MP)感染合并肝损害的临床特征,从而提高临床诊疗能力。方法对234例肺炎支原体肺炎(MPP)患儿进行肝功能、MP-DNA和MP耐药性等检测,回顾分析临床特征及相关实验室指标。结果234例MPP患儿中有24例合并肝损害,肝损害发生率为10.26%;47例肺炎支原体23S rRNA基因未发生突变,为大环内酯类敏感肺炎支原体(MSMP)感染,其中1例合并肝损害,肝损害发生率为2.13%;187例肺炎支原体23S rRNA基因发生点突变,均为A2063G突变,为大环内酯类耐药肺炎支原体(MRMP)感染,其中23例合并肝损害,肝损害发生率为12.30%,两者差异有统计学意义(P<0.05)。MP感染合并肝损害患儿的住院时间、CRP、LDH均高于肝功能正常患儿,差异有统计学意义(P<0.05)。结论儿童MP感染合并肝损害并不罕见,尤其是MRMP感染更易导致肝损害,病程相对较长,需引起临床儿科医生高度重视。

Objective The aim of this study is to determine the clinical characteristics of Mycoplasma pneumoniae infection with liver damage in Children in Wenzhou,so as to improve the clinical diagnosis and treatment ability.Methods A total of 234 children with Mycoplasma pneumoniae were enrolled for the detection of liver function,Mycoplasma pneumoniae DNA and Macrolide resistance mutations,and the clinical features and related laboratory indicators were reviewed and analyzed.Results Of the 234 children with MPP,24 had liver damage,the incidence of liver damage was 10.26%;47 cases of Mycoplasma pneumoniae 23S rRNA gene did not mutate,which was a macrolide-sensitive Mycoplasma pneumoniae(MSMP)infection,of which 1 case was combined with liver damage,and the liver damage rate was 2.13%;187 cases of Mycoplasma pneumoniae 23S rRNA gene suffered point mutation,all belonging to A2063G mutation and macrolide-resistant Mycoplasma pneumoniae(MRMP)infection,of which 23 cases were combined with liver damage,and the incidence rate was 12.30%,and the differences were statistically significant(P<0.05).The hospitalization time,CRP and LDH of children with MP infection and liver injury were higher than those with normal liver function,and the differences were statistically significant(P<0.05).Conclusion Children with Mycoplasma pneumoniae infection and liver damage are not uncommon.Especially,MRMP infection is more likely to cause liver damage and has a relatively long course of disease,which needs to be highly valued by clinical pediatricians.