87例流感合并肺炎支原体感染患儿临床特征

Clinical characteristics of influenza complicated with Mycoplasma pneumoniae infection in 87 children

目的探究儿童流感合并肺炎支原体感染的临床特征,为流感合并肺炎支原体感染诊断和预防提供参考。方法以2017年1-12月某院就诊并符合筛选条件的发热儿童328例为研究对象,依初步诊断结果将所有患儿分为流感合并肺炎支原体感染组(87例)、单纯流感感染组(149例)和单纯肺炎支原体感染组(92例),比较三组患儿血液指标和血清免疫指标。结果328例发热患儿中,87例(26.5%)为流感合并肺炎支原体感染,主要发生在秋冬季节1~6岁儿童。与单纯流感组相比,流感合并肺炎支原体感染组患儿出现咳嗽、咳痰和肺炎征象的情况明显偏多(P<0.05)。与单纯肺炎支原体感染组相比,流感合并肺炎支原体感染组患儿出现咳嗽、咳痰情况明显多。与单纯流感组和单纯肺炎支原体感染组相比,流感合并肺炎支原体感染组患儿体温处于中高热状态人数明显较高,患儿发热时间和住院时间更长,单核细胞百分比和中性粒细胞百分比明显升高,淋巴细胞百分比明显降低,IgG、IgA、IgM、C3和C4阳性异常情况所占比例明显较高。结论该地区流感合并肺炎支原体感染好发于秋冬季节,临床表现多出现较长时间的中高热症状,同时咳嗽、咳痰的征象相对普通流感更为严重,免疫指标检测结果明显异常。

Objective To explore the clinical characteristics of influenza complicated with Mycoplasma pneumo-niae(Mp)infection in children,and provide reference for diagnosis and prevention of influenza complicated with Mp infection.Methods 328 children with fever who met the screening criteria in a hospital from January to December 2017 were studied,according to the initial diagnostic results,children were divided into influenza combined with Mp infection group(n=87),simple influenza infection group(n=149)and simple Mp infection group(n=92),blood and serum immune markers of children in three groups were compared.Results Of 328 children with fever,87(26.5%)were with both influenza and Mp infection,mainly in children aged 1-6 years in autumn and winter.Compared with simple influenza group,symptoms of cough,expectoration and pneumonia in incldren in influenza combined with Mp infection group were significantly higher(P<0.05).Compared with simple Mp infection group,children in influenza combined with Mp infection group had more cough and expectoration.Compared with simple influenza group and simple Mp infection group,the number of children with moderate and high fever in influenza combined with Mp infection group was significantly higher,duration of fever and length of hospital stay were longer,percentage of monocyte and neutrophil increased significantly,percentage of lymphocyte reduced significantly,and proportions of abnormal IgG,IgA,IgM,C3,and C4 positive were significantly higher.Conclusion Influenza combined with Mp infection in this region occurs frequently in autumn and winter,clinical manifestations of influenza combined with Mp infection are characterized by prolonged symptoms of moderate and high fever,symptoms of cough and expectoration are more serious than those of common influenza,and immunological test results are obviously abnormal.