婴幼儿肺炎支原体肺炎临床特征及预后分析

Clinical Characteristics and Prognosis of Mycoplasma Pneumoniae Pneumonia in Infants and Young Children

目的:了解婴幼儿肺炎支原体肺炎(MPP)的临床特征及预后,以指导临床诊断和治疗。方法:回顾性分析2015年1月至2018年6月435例入住温州医科大学附属育英儿童医院确诊为MPP的患儿,按年龄段分为婴幼儿组139例、学龄前期组163例、学龄期组133例,比较患儿临床表现、实验室指标、影像学特点、治疗及预后。结果:婴幼儿组MPP临床症状明显。与其他年龄组比较,婴幼儿组C反应蛋白升高比例低,白细胞计数升高比例高,乳酸脱氢酶和血小板水平高。婴幼儿组胸部X线片以小片状或斑片状阴影为主,且易混合呼吸道病毒感染。婴幼儿组经积极合理治疗,预后良好。随访胸部X片表现为大叶性实质浸润影的婴幼儿97.50%(39/40)1个月内胸片恢复正常,临床表现消失,无后遗症及再发MP感染。结论:婴幼儿MPP临床症状明显,影像学表现以小片状或斑片状阴影为主,易合并呼吸道病毒感染,经积极有效治疗后,大部分可痊愈。

Objective:To investigate the clinical characteristics and prognosis of Mycoplasma pneumoniae pneumonia(MPP)in infants and young children,so as to provide reference for the clinical diagnosis and treatment.Methods:Retrospective analysis was performed on the clinical data of 435 infants and young children with MPP admitted into Yuying Children’s Hospital of Wenzhou Medical University from Jan.2015 to Jun.2018.According to different age groups,all children were divided into 139 cases in the infants and young children group,163 cases in the preschool age group,and 133 cases in the school age group.Clinical manifestations,laboratory indicators,imaging characteristics,treatment and prognosis of two groups were compared.Results:The clinical symptoms of MPP in the infants and young children group were significant.Compared with other age groups,the infants and young children group had lower proportion of increased C-reactive protein,higher proportion of increased white blood cell count,and higher lactate dehydrogenase and platelet levels.The chest X-ray of the infants and young children group was mainly in form of small flake or patchy shadow and easy to be infected by mixed respiratory tract virus.The infants and young children group had better prognosis after positive and reasonable treatment.And 97.50%(39/40)of the infants and young children with large lober parenchyma infiltration returned to normal chest X-ray within one month and had no clinical manifestations,no sequelae and recurrent MP infection.Conclusion:The clinical symptoms of infants and young children with MPP are significant and the imaging manifestations are mainly in form of small flake or patchy shadow,and easily to be infected by respiratory tract virus.With positive and rational treatment,most infants and young children with MPP can be cured.