血清肺炎支原体抗体结合胸部CT征象对小儿肺炎支原体肺炎的诊断价值

Diagnostic value of serum Mycoplasma pneumoniae antibody combined with chest CT signs for Mycoplasma pneumoniae pneumonia in children

目的 探讨血清肺炎支原体(MP)抗体结合胸部CT征象对小儿肺炎支原体肺炎(MPP)的诊断价值。方法回顾性分析2019年6月-2020年6月浙江大学附属儿童医院长兴院区儿内科收治的69例MPP和81例链球菌属肺炎(SP)患儿的临床资料,分别纳入MPP组和SP组。收集两组性别、年龄、发热时间和住院时间等资料;比较两组血清支原体-免疫球蛋白M(MP-IgM)和MP-IgG阳性率;分析两组胸部CT表现,比较两组淋巴结结影和胸腔积液情况、胸部CT征象发生率。结果 MPP组血清MP-IgM、MP-IgG抗体阳性率高于SP组(P<0.05);两组患儿淋巴结结影发生率差异无统计学意义;MPP组患儿胸腔积液发生率、淋巴结结影平均横径和胸腔积液厚度均低于SP组(P<0.05);MPP组患儿胸部CT支气管壁增厚、支气管血管束增厚、网状影征和磨玻璃征等胸部CT征象发生率高于SP组(P<0.05);两组肺气肿和支气管充气征等胸部CT征象发生率差异无统计学意义。结论 血清MP抗体结合胸部CT征象可较好鉴别小儿MPP和SP,具有较高的临床价值。

OBJECTIVE To investigate the diagnostic value of serum Mycoplasma pneumoniae(MP) antibody combined with chest CT signs in pediatric Mycoplasma pneumoniae pneumonia(MPP).METHODS The clinical data of 69 children with MPP and 81 children with Streptococcus pneumonia(SP) admitted to department of Pediatric Internal Medicine,Changxing Branch of Children′s Hospital Affiliated to Zhejiang University between Jun.2019 and Jun.2020 were retrospectively analyzed and included in the MMP and SP groups,respectively.The data such as gender,age,fever time and hospitalization time in both groups were collected.The positive rates of serum Mycoplasma pneumoniae-immunoglobulin M(MP-IgM) and MP-IgG were compared between the two groups.The chests CT manifestations of the both groups were analyzed,and the lymphadenography,pleural effusion and the incidence of chest CT signs were compared between the two groups.RESULTS The positive rates of serum MP-IgM and MP-IgG antibodies in MPP group were higher than those in SP group(P<0.05).There was no significant difference in the incidence of lymphadenography between the two groups.The incidence of pleural effusion,the average transverse diameter in lymphadenography and thickness of pleural effusion in MPP group were lower than those in SP group(P<0.05).The incidence of chest CT signs including thickening of bronchial walls and bronchial vascular bundles,reticular shadow,ground-glass opacity in MPP group was higher than that in SP group(P<0.05).CONCLUSION The serum MP antibodies combined with chest CT signs could better distinguish MPP from SP in children,which had relatively higher clinical value.