肺炎支原体耐药和儿童难治性肺炎支原体肺炎的关系研究

Study on the relationship between Mycoplasma pneumoniae resistance and refractory Mycoplasma pneumoniae pneumonia in children

目的分析肺炎支原体耐药和儿童难治性肺炎支原体肺炎(RMPP)的关系。方法采用回顾性研究法,以2020年1月~2023年1月期间开封市儿童医院治疗的88例肺炎支原体肺炎(MPP)患儿为研究对象,通过检测患儿肺泡灌洗液的肺炎支原体核酸将其分为耐药组(69例)和敏感组(19例)。比较两组患儿的免疫反应和实验室指标水平,并比较其临床症状、治疗情况及支气管镜下特征。结果与敏感组相比,耐药组患儿的白细胞、中性粒细胞、CD3^(+)T淋巴细胞、CD3^(+)CD4^(+)T淋巴细胞、CD3-CD8^(+)T淋巴细胞、C反应蛋白(CRP)、低密度脂蛋白(LDH)、肌酸激酶同工酶(CK-MB)水平比较差异无统计学意义(P>0.05),耐药组的热程、住院时间延长,糖皮质激素使用率、RMPP发生率、黏液栓阻塞发生率均升高,差异有统计学意义(P<0.05)。结论肺炎支原体耐药并不会对MPP患儿的免疫反应、炎性反应产生明显影响,但会延长热程、住院时间,提高RMPP、黏液栓阻塞发生率及糖皮质激素使用率。

Objective To analyze the relationship between Mycoplasma pneumoniae(MP)resistance and refractory Mycoplasma pneumoniae pneumonia(RMPP)in children.Methods A retrospective study was conducted on 88 children with Mycoplasma pneumoniae pneumonia(MPP)treated in Kaifeng Children's Hospital from January 2020 to January 2023.The patients were divided into a resistant group(69 cases)and a sensitive group(19 cases)based on the detection of Mycoplasma pneumoniae nucleic acid in alveolar lavage fluid.The immune response and laboratory index levels of the two groups were compared,and their clinical symptoms,treatment status,and bronchoscopic characteristics were also compared.Results Compared with the sensitive group,there was no significant difference in the levels of white blood cells,neutrophils,CD3^(+)T lymphocytes,CD3^(+)CD4^(+)T lymphocytes,CD3-CD8^(+)T lymphocytes,C-reactive protein(CRP),lactate dehydrogenase(LDH),and creatine kinase isoenzyme(CK-MB)in the resistant group(P>0.05).However,the resistant group had longer fever duration and hospital stay,higher rates of glucocorticoid use,RMPP occurrence,and mucus plug obstruction,with significant differences(P<0.05).Conclusion Mycoplasma pneumoniae resistance does not significantly affect the immune response and inflammatory response of MPP children,but it can prolong the fever duration,hospital stay,and increase the incidence of RMPP,mucus plug obstruction,and glucocorticoid use.