肺炎支原体感染并传染性单核细胞增多症患儿肺外并发症的临床特征  

Clinical Characteristics of Extrapulmonary Complication Induced by Mycoplasma Pneumoniae Infection Complicating with Infectious Mononucleosis Syndrome

作　　者：张宁[1] 王小艳[1] 

机构地区：[1]青岛市人民医院儿科,山东青岛266001

出　　处：《实用儿科临床杂志》2006年第16期1085-1086,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨肺炎支原体（MP）感染并传染性单核细胞增多症（传单）患儿肺外并发症的临床特征。方法对18例有不规则发热、颈部淋巴结大、咽炎、肝脾大、肺内感染等症状，经ELISA检测MP-IgM（＋）、EBV-IgM（＋），临床诊断为MP感染并传单的患儿进行回顾性分析。结果肺外并发症8例（44．4％），其中肝脏损害3例（16．6％），心肌损害1例（5．56％），心脏、肝脏同时受损2例（11．1％），泌尿系统损害、神经系统损害各1例（各5．56％）。并发症多于原发病后1周左右发生，无典型临床表现，仅1例脑炎以神经系统表现为首发症状，主要依靠辅助检查确诊。病例均予以大环内酯类治疗3周，更昔洛韦治疗5～7d，辅以并发症和支持治疗，均痊愈。结论MP感染并传单引起肺外并发症的发病率较单一感染高，多数临床症状不典型，易被原发病症状掩盖。少数以肺外表现为首发症状时，易造成误诊，早期诊断、规则治疗，预后良好。Objective To approach the clinical characteristics of extrapulmonary complication induced by mycoplasma pneumoniae （MP） infection and infectious mononucleosis syndrome. Methods The MP - IgM （ ＋ ）, EBV - IgM （ ＋ ） were determined by enzyme - linked immunosorbent assay. There were 18 cases infected with MP and infectous mononucleosis syndrome with abnormal fever, cervix lyphadenectasis, pharyngitis, liver and spleen intumescence, lung infection, and so on. They were analyzed by reviewing. Results There were 8 cases（44.4% ） with extrapulmonary complication, among them 3 cases（ 16.6% ） with liver injury, 1 case （5.56%） with heart injury, 2 cases（ 11.196 ） with both heart and liver injuries, 1 case（5.56 96 ） with urinary system injury （nephritis）, 1 case （5.56 96 ） with nervous system injury （encephalitis）. The complication usually arised 1 week after primary affection, but had no typical clinical symptoms. There was only 1 case with encephalitis who expressed the symptom of nervous system symptom firstly, and was clinically diagnosed by assistant examinations. All the cases recovered after 3 weeks＇ treatment with macrolides, 5 - 7 days with ganciclovir, and also with regular complication and support treatments. Conclusions The incidence of extrapulmonary complication induced by MP infection and infectous mononucleosis syndrome is higher than that by the single infection, and its clinical symptom isn＇t obvious and is easy to be covered by original illness. And a few showing the extrapulmonary as the first symptom is easily mistakenly diagnosed . As a result, the prognosis is favorable if we make subsidiary inspection and diagnosis as scon as possible and give it with regular treatment.

关 键 词：肺炎 支原体 传染性单核细胞增多症 肺外并发症 

分 类 号：R725.1[医药卫生—儿科]