耐药肺炎支原体肺炎患儿的临床特点  

Clinical Characteristics of Children with Macrolide-Resistant Mycoplasma Pneumoniae Pneumonia

作　　者：辛德莉[1] 王斯[1] 韩旭[2] 马少杰[1] 陈小庚[1] 

机构地区：[1]首都医科大学附属北京友谊医院儿科,北京100050 [2]中国石油天然气集团公司中心医院儿科,河北廊坊065000

出　　处：《实用儿科临床杂志》2010年第16期1213-1215,共3页Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金(30571973);北京市自然科学基金(7063075);北京中医局科技项目(JJ2005-5)

摘　　要：目的总结对大环内酯类抗生素耐药的肺炎支原体(MP)菌株感染所致MP肺炎(MPP)患儿的临床特点。方法选取2004年9月-2005年12月首都医科大学附属北京友谊医院儿科疑似MPP的住院患儿200例,应用巢式PCR和DNA测序技术检测64例确诊MPP患儿咽拭子标本MP耐药基因,在此基础上区分出耐药组和敏感组;观察2组患儿在性别、年龄、病程、最高体温、发热时间、住院时间、肺外并发症方面的差异,并应用SPSS11.5软件对其结果进行分析。结果 64例患儿中,咳嗽64例(占100%),发热64例(占100%);肺部有中细湿啰音52例(占81.3%),粗湿啰音2例(占3.1%),无肺部体征10例(占15.6%);有肺外并发症11例(占17.2%);胸部X线表现右肺病变者26例(占40.6%),左肺23例(占35.9%),双肺11例(占17.2%),无具体病灶4例(占6.3%)。外周血白细胞正常53例(占82.8%)。耐药组和敏感组患儿在性别(P=1.000)、年龄(P=0.800)、最高体温(P=0.082)、肺外并发症发生率(P=0.113)方面比较,差异无明显统计学意义;耐药组患儿的发热天数(P=0.024)、病程(P=0.047)和住院时间(P=0.015)均高于敏感组。结论耐药MP株感染者与非耐药MP株感染者相比,发热时间长,病程长,住院时间长。Objective To summarize the clinical feature of children infected with macrolide-resistant mycoplasma pneumoniae（MP） isolate.Methods Sixty-four clinical isolates of MP from 200 children hospitalized in Beijing Friendship Hospital Affiliated to Capital Medical University from Sep. 2004 to Dev. 2005 were determined by a nest-PCR and DNA sequencing.The patients were divided into 2 groups （drug-resistant group and drug susceptive group） depending on whether had MP drug resistant gene. Age,sex,course,maximum temperature,length of stay,febrile days and complications were compared between the 2 groups.The SPSS 11.5 software was used to analyze the data.Results Of these 64 cases of MPP, 64 cases （100% ）of the patients had cough and fever,52 cases（81.3%） of the patients had fine wet rales,2 cases（3.1%） had coarse wet rales,and 10 cases（15.6%） of the patients did not have pulmonary signs, 11 cases （17.2%） had complications;chest X-ray revealed right lung lesions in 26 patients（40.6%）,left lung lesions in 23 patients （35.9%）, both lung lesions in 11 patients（17.2%）,and nothing in 4 cases;routine blood test revealed that white blood cells were normal in 53 patients（82.8%）.Compared to drug-susceptive group, febrile days（P=0.024）,course（P=0.047）and length of stay （P=0.015）were longer in drug-resistant group, but no significant differences were found in sex（P=1.000）, age（P=0.800）, the highest body temperature（P=0.082） and complications（P=0.113）.Conclusions Compared to infected by MP without drug resistant gene,those infected by MP with drug resistant gene, febrile days,length of stay and course were longer.

关 键 词：肺炎支原体 耐药性 大环内酯类 

分 类 号：R725.6[医药卫生—儿科]