小儿肺炎支原体感染的临床特点及感染的相关危险因素分析

Analysis of the Clinical Characteristics of Mycoplasma Pneumoniae Infection and Related Risk Factors of Infection in Children

目的 分析小儿肺炎支原体感染(Mycoplasma Pneumoniae Infection, MPI)的特点和相关危险因素。方法 选取河北省沧州市献县中医医院2018年1月1日-2020年12月31日MPI患儿133例临床治疗资料进行回顾性分析,归纳和整理患儿的主要临床症状表现特点和致病因素。结果 (1)患儿临床特点:在133例患儿中,发热109例(81.95%)、乏力82例(61.65%)、头痛74例(55.64%)、咽痛95例(71.43%)、肌肉酸痛101例(75.94%)、咳嗽(初为干咳,部分表现为百日咳样咳嗽,后期伴有痰)104例(78.20%),病情严重者出现气促68例(51.13%)、喘憋71例(53.38%)。感染疾病中,主要以支气管肺炎、支气管炎、急性上呼吸道感染、化脓性扁桃体炎等为主,且支气管肺炎的占比最高,发热程度中,以高热与超高热为主,其他程度者人数较少;发热病程多为1~7d,8~14d者人数较少;胸部听闻细湿啰音、痰鸣音症状最为明显;咳嗽多为阵发性连声咳,患者血常规多数显示白细胞正常,但也有部分患者白细胞呈升高状;约有一半患者的C反应蛋白均为升高状;且心肌酶肌酸激酶同工酶也多呈升高状;X胸片检查可见患者的小斑点状模糊影明显;(2)感染危险因素分析:致病的危险因素包括体温控制不佳(持续发热超过7d)、皮疹、CRP>100mg/L、出凝血时间异常以及补体C3降低等(P <0.05)。结论 MPI患儿临床表现和致病因素多样,还需积极采取相关的预防措施和对症治疗,恰当诊断、治疗和合理使用抗菌药物,以此来减少病发率和促进患儿机体康复。

Objective To analyze the characteristics and related risk factors of Mycoplasma Pneumoniae Infection(MPI) in children. Methods The clinical treatment data of 133 children with MPI in Xianxian Traditional Chinese Medicine Hospital from January 1, 2018 to December 31, 2020 were selected for retrospective analysis, and the main clinical symptoms and pathogenic factors of the children were summarized and sorted out. Results(1) Clinical characteristics of children: Among 133 children, 109(81.95%) had fever, 82 cases(61.65%) were fatigue, 74 cases(55.64%) had headache, and 95(71.43%) had sore throat. 101 cases(75.94%) of muscle soreness, 104 cases(78.20%) of cough(dry cough at first, part of pertussis-like cough, later accompanied by sputum), 68 cases(51.13%) of shortness of breath in severe cases, and 71 cases(53.38%) of wheezing. The main infectious diseases were bronchopneumonia, bronchitis, acute upper respiratory tract infection and suppurative tonsillitis, and the proportion of bronchopneumonia was the highest. In the degree of fever, high fever and ultra-high fever are the main, although there are other degrees, the number is less. In the course of fever: Mostly 1~7 d, less 8~14 d. The symptoms of fine wet rales and phlegm sounds were the most obvious in the chest. Cough is mostly paroxysmal continuous cough. Blood routine examination showed that most patients had normal leukocytes, but some patients had elevated leukocytes. About half of the patients had elevated C-reactive protein. The isozymes of creatine kinase were also increased. X-ray examination showed that the small spot like fuzzy shadow of the patient was obvious.(2) Analysis of risk factors for infection: Risk factors for disease include poor temperature control(continuous fever for more than 7 days), skin rash, CRP> 100 mg/L, abnormal clotting time, and decreased complement C3(P < 0.05). Conclusion There are various clinical manifestations and pathogenic factors in children with MPI. It is necessary to actively take relevant preventive measures and symptomatic treatment, appropriate diagnosis, treatment and rational use of antibacterial drugs, so as to reduce the incidence and promote the recovery of children.