成人支原体肺炎、新冠肺炎、细菌性肺炎临床特征比较分析

Comparative analysis of clinical characteristics of adult mycoplasma pneumonia,COVID-19 and bacterial pneumonia

目的通过对下呼吸道感染患者血清中9种呼吸道病原体IgM抗体检测,结合患者临床表现、实验室及影像学检查,分析成人支原体肺炎与新冠肺炎、细菌性肺炎的临床特征。方法收集在北京怀柔医院呼吸内科2019年12月-2020年12月住院,诊断为呼吸道感染的132例患者作为研究对象。结果①支原体肺炎和新冠肺炎的易发群体主要集中在无基础病史的青壮年,细菌性肺炎多发生于有基础病史的老年人群;②支原体肺炎出现刺激性干咳症状,较新冠肺炎和细菌性肺炎多;③细菌性肺炎白细胞数量有明显变化;④新冠肺炎病灶多沿胸膜下分布,累及双肺,影像呈磨玻璃影;支原体肺炎主要沿支气管分布,且以单侧肺叶为主;细菌性肺炎和支原体肺炎实变影比重高于新冠肺炎。结论支原体肺炎和细菌性肺炎、新冠肺炎发病初期临床表现及实验室检查差异不大,但影像学分析具有细节差异,有助于几种肺炎的鉴别诊断。

Objective To analyze the clinical features of adult mycoplasma pneumoni,anew coronary pneumonia and bacterial pneumonia by detecting IgM antibodies against 9 respiratory pathogens ins erum of patients with lower respiratory tract infection,combiend with clinical manifestations,laboratory and imaging examinations.Methods A total of 132 patients with respiratory tract infection whoe rwe hospitalized in the Beijing Huairou hospital from December 2019to December 2020 were collected as research objectsR.esults①The susceptible groups of mycoplasma pneumonia and new coronary pnuemonia were mainly concentrated in young adults with no underliyng medical history,and bacterial pneumonia mostly occurred in the elderly with underlying medical history;②mycoplasma pneumonia group had irritating dry cough symptoms,which was more severe than the new coronary pneumonia group and bacterial pneumonia group;③the number of leukocytes in the bacterial pneumonia gropu changed significantly;④the new coronary pneumonia lesions weer mostly distributed along the subpleural,accumulating in both lungs,and imaging ground-glass opacity;mycoplasma pneumonia was mainly distributed along the bronchi,and the unilateral lung bleo was the proportion of consolidation shadows in bacterial punmeonia and mycoplasma pneumonia is higher than that in new coronary pneumnoia.Conclusion Mycoplasma pneumonia and bacterial pneumonia,and the initial clinical manifestations and laboratory tests of ne wcoronary pneumonia are not very different,but the imaging anyaslis has detailed differences,which are helpful for the differential diagnosis of the two.