肺炎支原体脑炎36例  

Clinical Analysis of Mycoplasma Pneumoniae Encephalitis in 36 Children

作　　者：李公利[1] 陈名武[1] 闫会丽[1] 陈兰举[1] 张慧洁[1] 

机构地区：[1]蚌埠医学院第一附属医院儿科,安徽蚌埠233004

出　　处：《实用儿科临床杂志》2006年第19期1328-1329,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨肺炎支原体(MP)脑炎小儿的临床特点。方法对经采用特异性免疫凝集法检测外周血和(或)脑脊液抗MP-IgM抗体阳性患儿36例的临床表现、实验室检查、治疗、转归情况进行回顾性分析。总结小儿MP脑炎的临床特点。结果MP脑炎多见于学龄期儿童,临床表现为头痛、呕吐(21/36),发热(17/36),抽搐(9/36),昏迷(3/36),嗜睡、精神萎靡(2/36)和肢体活动障碍(1/36)。33例血清抗MP-IgM阳性,9例脑脊液抗MP-IgM阳性,其中6例血清和脑脊液抗MP-IgM同时阳性。6例咳嗽、流涕。17例拍摄胸片,10例异常。11例检查C-反应蛋白(CRP)均升高。患儿均好转出院。结论中枢神经系统感染患儿如果脑脊液呈病毒性脑炎改变,胸片检查有肺炎X线表现,CRP升高,要考虑MP感染可能。确诊有赖于血清和(或)脑脊液抗MP-IgM检查。Objective To explore clinical characteristics of mycoplasma pneumoniae（MP） encephalitis in children. Methods Specific immune agglutination was used to detect anti - MP IgM in serum and/or in cerehrospinal fluid（CSF ）. Clinical data of 36 patients, whose anti - MP IgM were positive, were analyzed retrospectively. Results The incidence of MP encephalitis was mainly in school age children. The clinical manifestations included fever （ 17/36 ）, headache, vomiting （ 21/36 ）, convulsion （ 9/36 ）, coma （ 3/36 ）, lethargy, depressed （ 2 / 36）, and limbs disturhanced（ 1/36）. The changes of CSF were consistent with those of viral encephalitis; 33 cases of serum MP - IgM were positive;9 cases of CSF MP - IgM were positive,of which,6 cases of serum and CSF MP - IgM were positive simultaneously. Six patients had cough and nasal discharge. Chest X- rays were performed in 17 patients and abnomal results were found in 10 cases, which had a representation of pneumoniae. C- reactive protein（CRP）were tested in 11 patients, in which the levels of CRP were elevated. All patients discharged with an improved condition. Conclusions For the patients with central nervous systern（CNS） manifestations of unknown cause, if the changes of CSF are consistent with those of virus encephalitis and the majority of chest X - rays have pneumoniac representations, and with an elevated level of CRP. MP encephalitis shall be considered. Final diagnosis depends on the test of MP - IgM in serum and/or in CSF samples.

关 键 词：脑炎 肺炎 支原体 儿童 

分 类 号：R725.1[医药卫生—儿科]