摘要
目的了解不同年龄儿童肺炎支原体肺炎(MPP)的临床特征。方法收集2006年10月-2007年9月本院呼吸病房经ELISA法检测血清肺炎支原体(MP)IgM结合PCR方法确诊的161例MPP患儿,对其临床资料进行总结。所有患儿按年龄分为婴幼儿组(≤3岁)、学龄前组(>3～6岁)和学龄组(>6岁)。比较不同年龄儿童在临床症状、肺部体征、胸部X线表现、肺外并发症情况及合并其他病原体方面的差异。结果婴幼儿组MPP起病相对急,咳痰及喘息症状相对明显,肺部干湿啰音多,体温相对低,平均热程短;学龄组儿童多表现为高热,干咳症状重,肺部体征轻,平均发热时间长。MPP患儿胸部X线表现具有多样性。小叶实质浸润是各个年龄组最常见的胸部X线征象,学龄前组及学龄组肺段实质浸润明显多于婴幼儿组。消化系统、心脏、肾脏、皮肤等是MP感染常累及的肺外部位,其中除消化系统损伤学龄儿童少于其他二组儿童外(P<0.01,0.05),其他方面各年龄组均无明显差异。胸膜受累在年长儿相对多见,多为胸膜增厚或少量积液,少数引起大量胸腔积液,是重症MPP的主要表现之一。各个年龄组均易并多种病原感染。结论不同年龄儿童MPP在临床症状、肺部体征及胸部X线表现等方面均存在一定差异,须结合血清学等检查才能帮助早期诊断。
Objective To explore the characteristics of mycoplasma pneumoniae pneumonia（MPP） in children in different ages.Me-thods The chief clinical manifestations of 161 hospitalized children with MPP confirmed by ELISA positive mycoplasma pneumoniae（MP） IgM and PCR techniques from respiratory ward in our hospital were analyzed retrospectively from Oct.2006 to Sep.2007.All the children with MPP were classified into 3 groups according to their ages as follows：infants（≤3 years old） group,preschool children（between 3 and 6 years old） group and school-aged children（〉6 years old） group.The differences in children with MPP from different ages in terms.Of clinical symptoms,pulmonary signs and chest X-rays,extrapulmonary complications and concomitant organisms were compared.Results The clinical characteristics of MPP in infants were different from those in older children.In the infants who had more wet coughs,wheezings and rales,the onset of illness was more acute,but the degree in temperature was lower and the length of fever time was shorter,whereas,the majority of school-aged children with MPP showed high fever,severe nonproductive coughs,slight pulmonary signs and longer fever time.The children with MPP had multiple presentations of chest X-rays.Lobular parenchymtous infiltration was among common pulmonary X-ray findings in all groups.More segmental parenchymtous infiltration of chest X-ray could be found in preschool or school-aged children than that in infants.Digestive system,cardiac system,kidney,skin and so on were common extrapulmonary sites that could be impaired by MP infection.There were no differences among the 3 age groups in other respects except that less digestive system impairment could be found in school-aged children compared with the other 2 age groups.There were more pleural abnormalities（often being pleural thicken or small effusion,seldom large effusion which would be one of the main manifestations of severe MPP） in older children than in younger ones.Children with MPP in all
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2008年第16期1255-1257,共3页
Journal of Applied Clinical Pediatrics
关键词
肺炎支原体
肺炎
临床特征
儿童
mycoplasma pneumoniae
pneumonia
clinical characteristic
child
