肺炎支原体感染与毛细支气管炎的相关性分析

analysis on the relation of bronchiolitis and infection of mycoplasmas pneumoniae

目的 探讨肺炎支原体 (MP)感染与毛细支气管炎的相关性。方法 前瞻性对 137例毛细支气管炎患儿采用ELISA方法进行血清MP IgM测定 ,并设IgM阳性为MP感染组、IgM阴性为对照组 ,进行比较分析。结果 137例毛细支气管炎患儿中 ,MP IgM阳性 2 2例 (16 % ) ,其临床特征为 :1～ 6月龄 10例 (4 5 5 % )、6个月～ 2岁 12例 (5 4 5 % )。冬春 13例 (5 9 1% ) ,夏秋 9例 (4 0 9% )。均有咳嗽、喘憋表现和发作性呼吸困难 ,发热 14例 (6 3 6 % )。肺部片状阴影 12例 (5 4 5 % ) ,白细胞总数 >15× 10 9/L 9例 (4 0 9% )。肺外表现 :神经系统 2例 (9 1% ) ,皮疹 4例 (18 2 % ) ,肝功能ALT升高 9例(4 0 1% )。无心力衰竭发生。病程平均 19d。 2～ 6周大环内酯类药正规治疗 2 0例 (10 0 % )有效。结论 肺炎支原体急性感染可引起毛细支气管炎 ,病程较长 ,肺外表现多 ,肺部X线多伴有片状阴影。

Objective To investigate the relation of bronchiolits and infection of mycoplasmas pneumonlae (MP).Methods The blood serum MP-IgM of 137 patients with bronchiolitis were detected with ELTSA test,the clinical features of patients in MP-IgM positive group and those in MP-IgM negative group were contrasted.Results 22 of 137 patients with bronchiolitis were MP-IgM negative (16%).Among 22 cases, between the age of one months and six months was 10 cases (45.5%), the range of age from 6 months to two years was 12 cases (54.5%), 13 cases in winter and spring (59.1%), 9 cases in summer and autumn (40.9%),fever 14 cases (63.6%), the white blood cell over 15×10 9/L 9 cases (40.9%), the scattered areas of consolidation on the chest radiographs were found in about 54.5% of patients (12/22), the paroxysmal wheezy cought, asthma and dyspnea were common manifestations in 22 cases.Other systemic manifestations,such as abnormal of nerve system was 2 cases (9.1%), skin eruption 4 cases (18.2%), the rise of Alanine aminotransferase 9 cases (40.1%), but none of heart failure was found.The period of disease was averagly 19 days, 20 treated by macrolides medicine for 2～6 weeks were effective (100%).Conclusion It is noted that the bronchiolitis caused by MP infection have longer period of disease and there are more other systemic manifestations and the scattered areas of consolidation on the chest radiographso macolides medicine is effective.