肺炎支原体肺炎患儿肺功能变化的意义  

Changes of Pulmonary Function in Children with Mycoplasmal Pneumoniae Pneumonia

作　　者：李芳[1] 聂亚玲[1] 常宏宇[1] 王颖[1] 张霞[1] 曾立[1] 赵丽芳[1] 

机构地区：[1]第二炮兵总医院儿科,北京100088

出　　处：《实用儿科临床杂志》2009年第22期1732-1733,1736,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨肺炎支原体肺炎(MPP)患儿肺功能变化及临床意义。方法检测MPP患儿血清MP特异性抗体MP-IgM。采用瑞士EasyOneTMSpirometer肺功能仪测定MPP患儿急性期及恢复期用力肺活量(FVC)、1秒钟用力呼气容积(FEV1)、第一秒最大呼气率(FEV1/FVC%)、最大呼气峰流速(PEF)、用力呼气中段流速(FEF25%～75%)、用力呼气25%流速(FEF25%)、用力呼气50%流速(FEF50%)、用力呼气75%流速(FEF75%),并进行统计学分析。结果30例患儿急性期FVC、FEV1、FEV1/FVC%、PEF、FEF25%～75%、FEF25%、FEF50%、FEF75%均有不同程度降低,以PEF、FEF25%～75%、FEF25%、FEF50%、FEF75%下降较为明显,均值中FVC<80%,FEV1<80%,FEV1/FVC%>75%。恢复期各项指标均明显改善,除FVC外,其他各项指标与急性期比较均有统计学差异(Pa<0.05)。MPP高滴度组患儿急性期及恢复期肺功能指标均较低滴度组降低,仅急性期FEV1、FEF25%～75%、FEF75%三项指标有统计学差异(Pa<0.05)。结论MPP患儿急性期大、小呼吸道功能均有不同程度的损伤,以小呼吸道损伤较为明显,多数患儿表现为限制性通气障碍,恢复期肺功能明显改善。MP抗体滴度明显增高者可能有更为严重的肺功能损伤。Objective To explore pulmonary function changes in children with mycoplasmal pneumoniae pneumonia（MPP）. Methods A total of 30 children with MPP were recruited into this study. Serum MP - IgM of all the patients were detected. A Switzerland puhnonary tes- ting system （EasyOneTM Spirometer） was used to examine patients＇ pulmonary function during both acute phase and recovery phase,including forced vital capacity （FVC） ,forced expiratory volume in one second（ FEV1 ） ,FEV1/ FVC % ,peak expiratory flow（PEF） ,forced expiratory flow during middle half of FVC （ FEF25% -75% ） , FEF after 25% of vital capacity had been expelled （ FEF25% ）, FEF after 50% of vital capacity had been expelled （ FEFS0% ） and FEF after 75% of vital capacity had been expelled （ FEF75% ） ,and the variation were analyzed. Results Significanty reductions were observed in FVC,FEVI ,FEV1/ FVC % ,PEF,FEF25% -75% ,FEF25% ,FEF50% and FEF75% in all the 30 cases during acute phase. PEF, FEF25% -75% , FEF25% , FEF50% and FEF75% decreased more markedly. The mean of both FVC and FEV1 〈80% ,and the mean of FEVI/FVC % 〉75%. Analysis of variance between acute phase and recovery phase revealed statisti- cally significant differences in FEV1, FEV1/FVC %, PEF, FEF25% - 75%, FEF25%, FEF50% and FEF75% （ P, 〈 0.05 ）. The high MP - IgM titer group had lower FEV1, FEF25 % -75% and FEF75 % than the low MP - IgM titer group in acute phase （P 〈 O. 05 ）. Conclusions MP infection in children with pneumonia results in impaired puhnonary function in both large airway and small airway, especially in small airway. Most of the children have restrictive impairment in acute phase,and improve well in recovery phase. It is supposed that high serum MP- IgM titer may result in more serious pulmonary function damage.

关 键 词：肺炎支原体 肺炎 肺功能 儿童 

分 类 号：R725.6[医药卫生—儿科]