某三甲医院不同年龄儿童支原体肺炎的病例分析

Case analysis of mycoplasma pneumonia in children of different ages in a third grade hospital

目的 探讨不同年龄儿童支原体肺炎(mycoplasma pneumonia, MPP)的临床特征差异。方法 选取2019年8月—2021年8月郑州大学附属儿童医院收治的住院MPP患儿246例,按照患儿年龄将其分为两组,其中年龄≤3岁的患儿114例为A组,>3岁患儿132例为B组,比较两组临床症状、体征、实验室指标、胸部X线表现以及治疗与转归情况。结果 A组喘息发生率(33.33%)、咳痰发生率(39.47%)、呼吸困难发生率(28.07%)、气促发生率(50.88%)、恶心呕吐发生率(49.12%)高于B组(14.39%、13.64%、3.79%、12.88%、9.09%)(P<0.05);A组出现肺外症状17例(14.91%),B组出现肺外症状6例(4.55%),差异有统计学意义(P<0.05);A组CRP、IgA、IgG、IgM、C3水平低于B组,中性粒细胞减少或缺乏发生率(16.67%)高于B组(4.55%)(P<0.05);A组小叶实质浸润发生率(78.07%)、肺段实质浸润发生率(57.02%)高于B组(17.42%、31.06%)(P<0.05);A组完全使用激素患儿比例(37.72%)高于B组(17.42%)(P<0.05);A组完全治愈率(59.65%)与B组完全治愈率(58.33%)无明显差异(P>0.05)。结论 不同年龄MPP患儿在主要症状、体征、实验室指标、胸部X线特征等方面均存在一定差异,应引起重视。

Objective To investigate the clinical characteristics of mycoplasma pneumonia(MPP) in children of different ages.Methods A total of 246 children with MPP hospitalized from Aug. 2019 to Aug. 2021 were selected and divided into two groups according to their age. Among them, 114 children aged ≤3 years were divided into group A and 132 children >3 years old were divided into group B. The clinical symptoms and signs, laboratory indexes, chest X-ray manifestations, treatment and outcome were compared between the two groups.Results The incidence of wheezing(33.33%), expectoration(39.47%), dyspnea(28.07%), shortness of breath(50.88%), nausea and vomiting(49.12%) in group A were higher than those in group B(14.39%, 13.64%, 3.79%, 12.88%, 9.09%)(P<0.05);There were 17 cases(14.91%) who had extrapulmonary symptoms in group A and 6 cases(4.55%) who had extrapulmonary symptoms in group B, the difference was statistically significant(P<0.05);The levels of CRP, IgA, IgG, IgM and C3 in group A were lower than those in group B, and the incidence of neutropenia or neutropenia(16.67%) was higher than that in group B(4.55%)(P<0.05);The incidence of parenchymal infiltration in lobule(78.07%) and lung segment(57.02%) in group A was higher than those in group B(17.42%, 31.06%)(P<0.05);The proportion of children in group A who used hormones completely(37.72%) was higher than that in group B(17.42%)(P<0.05). The complete cure rate of group A(59.65%) and group B(58.33%) had no significant difference(P>0.05).Conclusion Children with MPP of different ages have some differences in major symptoms, signs, laboratory indicators, chest X-ray characteristics and other aspects, which should attract enough attention.