肺炎支原体分型与肺炎患儿临床症状相关性

Correlation between the genotype of Mycoplasma pneumoniae and clinical symptoms of pediatric pneumonia

目的研究肺炎支原体分型与肺炎患儿临床症状的相关性。方法选择2017年11月至2018年5月在郑州大学附属儿童医院儿科治疗的确诊为肺炎支原体(MP)肺炎的患儿86例。采用自行设计的调查表研究患儿基本资料,包括性别、年龄、既往史、入院24h临床症状、实验室指标、影像学症状等。利用实时定量PCR技术分析样本中肺炎支原体基因拷贝数,并设计引物分析MP基因分型。结果共检出MP低拷贝量患儿15例(17.44%),中拷贝量患儿24例(27.91%),高拷贝量患儿47例(54.65%);P1-I型MP 80例(93.02%),P1-II型MP 6例(6.98%)。患儿MP基因拷贝数与病程≥10d,体温>39℃,畏寒或寒战,GRA%,GRA,CRP,PCT,大片状实变/不张,胸腔积液呈正相关,且为弱或中等相关。MP基因拷贝数与LYM%,LYM呈负相关,且为弱相关。患儿MP分型与体温>39℃呈负相关,且为弱相关。结论 MP肺炎患儿上呼吸道MP数量与患儿临床表现,实验室指标和影像学特征存在一定相关性,因此上呼吸道MP数量可成为MP肺炎病情评估的指标之一。

Objective To study the correlation between the genotype of Mycoplasma pneumoniae(MP)and clinical symptoms of pediatric pneumonia.Methods 86 children with MP pneumonia diagnosed in the affiliated children′s hospital of Zhengzhou university from November 2017 to May 2018 were selected.The selfdesigned survey questionnaire was used to collect basic data of the children,including gender,age,past history,clinical symptoms within 24 hours after admission,laboratory indicators,and imaging symptoms.The quantification of MP gene copy number was performed using real-time quantitative PCR(FQ PCR)technology and primers were designed to analyze MP genotypes.Results There were 15cases(17.44%)of low copy number of MP,24cases(27.91%)of medium copy number,47cases(54.65%)of high copy number,80 cases of P1-I type(93.02%),and 6cases(6.98%)of P1-II type.The MP gene copy number showed a weak or moderate positive correlation with disease course≥10days,body temperature>39°C,chills or shiver,GRA%,GRA,CRP,PCT,large patchy consolidation/atelectasis and pleural effusion,as well as a weak negative correlation with LYM% and LYM.There was a weak negative correlation between MP genotype and body temperature>39°C.Conclusion There is a certain correlation between the bacterial count of MP in upper respiratory tract and the clinical manifestations,laboratory parameters and imaging features of children with MP pneumonia.Therefore,the bacterial count of MP in upper respiratory tract can be one of the important indicators for assessing the condition of MP pneumonia.