小儿肺炎支原体肺炎136例临床分析

Clinical analyses of 136 children with mycoplasmal pneumoniae

目的 :探讨小儿肺炎支原体肺炎临床特点、血清学检测及诊疗措施 ,并评价其疗效。方法 :总结 1 36例小儿肺炎支原体肺炎临床资料 ,包括临床特征、X线检查、血清学检测以及治疗和转归。结果 :本病冬春季发病率最高 ,占 5 9.6 %。 5a以上儿童多见 ,共 1 0 4例 ,占总病例数 76 .5 % ,5a以下 32例 ,占 2 3% ,年龄最小为 1 0个月 ,发病年龄有趋小的倾向。临床表现为发热、咳嗽、气促 ,小婴儿常出现喘憋。肺外并发症较多。胸部X线检查 :肺部病变多以小片状阴影为主 ,可为单侧或双侧。临床及X线表现与病毒性及细菌性肺炎无特异性。血清学检测 1 36例血冷凝集试验 ,1 0 5例阳性 ,其中 6 0例同时作MP -IgM检测 ,全部阳性。所有病例使用红霉素或阿奇霉素治疗 ,治愈率 1 0 0 %。结论 :诊断为肺炎的患儿 ,在持续发热或反复咳嗽而疗效欠佳时 ,要尽早作血清学或病原学检查 ,以确诊或排除肺炎支原体肺炎。冷凝集试验可作为诊断本病的重要检查方法之一 ,MP -IgM检测灵敏性和特异性较高 ,有早期诊断价值。

Objective:To investigate the clinical characteristics, serological identification, diagnosis and treatment of mycoplasmal pneumoniae pneumonia(MPP) in child. Methods:To analyze the clinical featues, X ray and serological results in 136 patients with MPP. Results: The incidence of the disease is 23%, 104 children older than 5 years in 136 are infected (76 5%), those younger than 5 years are 32 patients(23%). Young children are prone to infect MPP. The clinical characteristics of MPP is fever, cough and out of breath. And young children can have symptoms just like asthma and other multiple syndromes. The changes of X ray are small shadows in one or both sides of lungs. There is no distinctive difference among MPP, virosis, and bacterial pneumonia. Cold aggliutination test in 105 patients of 136 is positive. We also had 60 patients tested MP IgM and all are potisive. All patients are treated with erythromycin and azithromycin with the cure rate 100%.Conclusions: To diagnose or eliminate MPP, the serology and pathogeny tests should be conducted as early as possible for those children with diagnosed pneumonia and with the symptoms of continuing fever and repeated cough without effective cure effect. Cold agglutination test can be a effective way to diagnose MPP. With its high precision and specialty, MP-IGM is applicable in diagnosis in early progress. Macrolides, such as erythromycin, are effective to MPP.