不同年龄儿童大叶性肺炎临床表现及病原学差异

Clinical Manifestations and Etiology Difference of Lobar Pneumonia in Children with Different Ages

目的分析儿童大叶性肺炎的临床表现及病原学特点,为大叶性早期识别及治疗提供依据。方法收集2013年4月至2019年2月在我院诊断为大叶性肺炎的患儿533例临床资料并进行回顾性分析。结果<1岁组患儿出现喘气、气促,肺部啰音的比例明显高于其他各组(P<0.001),发热、呼吸音减低明显低于其他各组(P<0.001)。常见病原体依次为:肺炎支原体(MP)(42.03%),细菌(29.46%)及混合(28.51%);并呈现年龄差异,1岁以内以细菌(49.06%)及混合感染(50.94%)为主;随年龄增长,MP比例逐渐升高(P<0.001),细菌、混合感染逐渐下降(P<0.001)。结论当婴儿出现咳嗽、喘息、气促、明显肺部啰音,年长儿出现反复发热、咳嗽时,需警惕发展为大叶性肺炎。婴儿以细菌感染及混合感染为主;随着年龄增加,肺炎支原体感染逐渐增加。

Objective to analyze clinical manifestations and etiological characteristics of lobar pneumonia children,and provide basis for early identification and treatment of lobar pneumonia.Methods collcet clinical data of 533 cases lobar pneumonia children diagnosed in our hospital from April 2013 to February 2019 for analysis and review.Results proportion of wheezing,shortness of breath and lung rales in<1-year-old group were significantly higher than other groups(P<0.001),fever and respiratory sounds were significantly lower than other groups(P<0.001).Common pathogens were as follows:mycoplasma pneumoniae(MP)(42.03%),bacteria(29.46%)and mixed infection(28.51%);with ages difference,bacteria(49.06%)and mixed infection(50.94%)were main pathogens for within 1 year old;with increase of age,proportion of MP increased gradually(P<0.001),and bacterial and mixed infection decreased gradually(P<0.001).Conclusion when infants had cough,wheezing,shortness of breath and obvious lung rales,older children had repeated fever and cough,it is necessary to be alert risks of lobar pneumonia,mainly infection of mycoplasma pneumoniae,which increased with age.