摘要
目的分析肺炎支原体肺炎（MPP）并栓塞6例患儿的临床资料，提高对本病临床特点、诊断及治疗的认识。方法对2010年1月至2015年6月南京医科大学附属南京儿童医院收治的6例MPP并栓塞病例的临床资料进行回顾性分析。结果6例患儿年龄3岁2个月-13岁10个月，其中男3例，女3例。6例均有高热、血清肺炎支原体抗体（MP-IgM）滴度强阳性（≥1：160）、痰荧光定量（FQ）-MP DNA阳性，胸部影像学检查符合肺炎改变。4例合并肝功能损害，4例D二聚体升高，5例红细胞沉降率不同程度升高，5例合并胸腔积液或胸膜炎。6例均通过影像学检查确诊栓塞，其中1例左肾动脉栓塞，1例左下肢胭动脉栓塞，1例右侧大脑中动脉栓塞合并脑梗死，1例为右侧锁骨下静脉、右上肢静脉栓塞，1例双侧基底动脉及大脑后动脉栓塞合并脑梗死，1例右下肺静脉远端及右下肺动脉分支栓塞。1例行血栓取出术，6例均经过抗感染、抗凝、小剂量量糖皮质激素等治疗，1例发生脑疝死亡，5例好转。结论MPP常伴有高凝状态，栓塞可发生于全身各脏器，发生脑梗死预后差，故应提高对MPP合并栓塞的潜在风险认识，早期诊断，及时行抗凝、溶栓治疗，以降低病死率及致残率。
Objective To investigate the clinical data of Mycoplasma pneumoniae pneumonia（MPP） complicated with embolism in children, and to improve the understanding of the clinical features, diagnosis and treatment of the disease. Methods Six cases of MPP complicated with embolization, who were treated at Nanjing Children＇s Hospital Affiliated to Nanjing Medical University from January 2010 to June 2015, were analyzed retrospectively. Results The ages of 6 cases ranged from 3 years and 3 months old to 13 years and 10 months old,and 3 cases were boys,3 cases were girls. All of 6 patients had high fever,positive anti -Mycoplasma IgM antibody （ ≥ 1 ： 160） and sputum fluorescence quantitative - Mycoplasma pneumonia （ FQ - MP DNA）, and all the chest imaging was consistent with pneumonia. Among 6 patients ,4 cases complicated with liver function damage ,4 cases had D - dimer rise,5 cases of erythrocyte sedimentation rate increased at different degree, while pleural effusion or pleuritis was found in 5 cases. The region of embolism in the cases included left renal artery in 1 case,the left popliteal artery in 1 case ,the right middle cerebral artery em- bolism combined with cerebral infarction in 1 case ,the right subclavian vein embolism combined with right upper extremity embolism in 1 case, the basilar artery and bilateral posterior cerebral artery embolism combined with cerebral infarction in 1 case, and the other case involved the right pulmonary embolism. One case received thrombus dislodgment operation, and all of 6 cases were given the treatment including anti - infection, anticoagulation and low dose of glucocorticoid therapy, among whom 1 case died of cerebral hernia, and the other 5 cases improved. Conclusions MPP is often complicated with hypercoagulative state and potentialized to thrombosis,and thrombus may occur in vessels of whole body organs,and cerebral infarction had poor prognosis. Consequently, doctors should be aware of the potential risk factors for thrombosis. Early diagnosis and prompt a
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2016年第4期288-291,共4页
Chinese Journal of Applied Clinical Pediatrics
关键词
肺炎支原体肺炎
栓塞
血栓
儿童
Mycoplasma pneumoniae pneumonia
Embolism
Thrombus
Child
