儿童肺炎流感嗜血杆菌合并肺炎支原体感染的临床特征

Clinical Characteristics of Haemophilus Influenzae Pneumonia with Mycoplasma Pneumoniae Infection in Children

目的:分析儿童肺炎流感嗜血杆菌(Hi)、肺炎支原体(MP)合并感染的临床特征。方法:选取2019年1-12月在厦门市儿童医院感染科住院的181例肺炎患儿。根据感染情况将患儿分为MP组86例、Hi组58例、合并感染组(MP合并Hi)37例。记录患儿的临床表现、血常规、C反应蛋白(CRP)、降钙素原(PCT)、肺部CT表现。结果:三组在婴儿期、幼儿期、学龄前期、学龄期占比比较,差异均有统计学意义(P<0.05)。Hi组患儿婴儿期占比高于合并感染组和MP组,合并感染组患儿幼儿期占比高于MP组,MP组患儿学龄前期、学龄期占比均高于Hi组,差异均有统计学意义(P<0.017)。三组在青春期占比比较,差异无统计学意义(P>0.05)。三亚组性别、发热比例、高热比例、发热天数、咳嗽天数、肺不张情况比较,差异均无统计学意义(P>0.05)。各病原亚组和对照组的WBC、NEUT%、LYMPH%、MONO%、CRP、PCT比较,差异均有统计学意义(P<0.05)。Hi亚组WBC高于合并感染亚组、MP亚组和对照组,差异均有统计学意义(P<0.017);MP亚组、对照组、合并感染亚组三组之间WBC比较,差异均无统计学意义(P>0.05)。各亚组间NEUT%、LYMPH%、MONO%、Hb、PLT、CRP、CRP分级、PCT比较,差异均无统计学意义(P>0.017);各亚组NEUT%、MONO%、CRP、PCT均高于对照组,LYMPH%均低于对照组,差异均有统计学意义(P<0.017)。结论:Hi、MP合并感染儿童肺炎主要集中在幼儿期、学龄前期儿童。MP、Hi合并感染后WBC可处正常范围,NEUT%、CRP、PCT升高,LYMPH%下降,但难以通过临床表现、血常规、CRP、PCT鉴别Hi、MP合并感染肺炎,Hi肺炎,MP肺炎。

Objective:To analyze the clinical characteristics of haemophilus pneumoniae(Hi)and mycoplasma pneumoniae(MP)combined infection in children.Method:A total of 181 children with pneumonia hospitalized in the department of infection,Xiamen Children’s Hospital from January to December 2019 were selected.According to the infection status,the children were divided into MP group(n=86),Hi group(n=58)and combined infection group(MP combined with Hi)(n=37).The clinical manifestations,blood routine,C-reactive protein(CRP),procalcitonin(PCT)and lung CT were recorded.Result:Comparison of the proportions of the three groups in infancy,early childhood,pre-school age and school age,the differences were statistically significant(P<0.05).The proportion of infants in the Hi group was higher than that in the combined infection group and MP group,the proportion of infants in the combined infection group was higher than that in the MP group,the proportions of pre-school age and school age in MP group were higher than those in Hi group,the differences were statistically significant(P<0.017).There was no statistical significance in the proportion of puberty among the three groups(P>0.05).There were no significant differences in gender,fever proportion,high fever proportion,fever days,cough days and atelectasis among three subgroup(P>0.05).Comparison of WBC,NEUT%,LYMPH%,MONO%,CRP,PCT of each pathogen subgroup and control group,the differences were statistically significant(P<0.05).WBC of Hi subgroup was higher than that of combined infection subgroup,MP subgroup and control group,the differences were statistically significant(P<0.017).There was no significant difference in WBC among MP subgroup,control group and combined infection subgroup(P>0.05).There were no significant differences in NEUT%,LYMPH%,MONO%,Hb,PLT,CRP,CRP grading and PCT among all subgroups(P>0.017).NEUT%,MONO%,CRP and PCT in each subgroup were higher than those in the control group,and LYMPH%was lower than that in the control group,the differences were statistically significant(P<0.017).Conclusion:Hi,MP combined infection of children with pneumonia mainly concentrated in early childhood,pre-school children.After MP and Hi infection,WBC can be in the normal range,NEUT%,CRP and PCT are increased,and PCT is decreased.However,it is difficult to distinguish Hi and MP infection,Hi pneumonia and MP combined pneumonia by clinical manifestations,blood routine,CRP and PCT.