儿童支原体肺炎肺泡灌洗液检测与临床关系探讨  

Investigation on the relationship between bronchoalveolar lavage fluid and clinical features of children with mycoplasma pneumoniae pneumonia

作　　者：范丽萍[1] 孙惠泉[1] 黄莉[1] 李东[1] 郝创利[1] 周月丽[1] 闻芳[1] 

机构地区：[1]苏州大学附属儿童医院呼吸科,江苏苏州215003

出　　处：《临床肺科杂志》2013年第10期1755-1757,共3页Journal of Clinical Pulmonary Medicine

基　　金：苏州科技计划项目(No SYS201243)

摘　　要：目的探讨儿童支原体肺炎(MPP)支气管肺泡灌洗液(BALF)中MP-DNA基因阳性患儿的临床特征。方法对行纤维支气管镜检查和支气管肺泡灌洗的94例MPP患儿,采用荧光实时定量PCR(FQ-PCR)检测BALF中MP-DNA基因,根据检测结果分为实验组61例(肺泡灌洗液MP-DNA阳性)与对照组33例(肺泡灌洗液MP-DNA阴性),对两组的临床特点进行比较。结果实验组学龄儿显著多于对照组(P<0.05);高热、CRP升高、胸部X线和/或CT检查肺不张及胸腔积液明显高于对照组(P<0.05);支气管镜下表现及BALF细胞学分类两组差异无统计学意义(P>0.05)。结论以学龄儿、高热、CRP升高、肺不张、胸腔积液为临床特点的MPP,BALF中MP-DNA基因阳性多见,可能与患儿体内MP不易清除和存在较强的免疫反应有关,临床需适当延长大环内酯类抗生素治疗疗程及注重免疫治疗。Objective To explore the clinical features of positive MP-DNA gene in brenchoalveolar lavage fluid （BALF） of chil- dren with mycoplasma pneumonia pneumonia （MPP）. Methods 94 children with MPP from January 2010 to June 2011 were given flexi- ble bronchoscopy and bronehoalveolar lavage examination, and then were divided into the experiment group with 61 cases （ BALF MP-DNA positive） and the control group with 33 cases （ BALF MP-DNA negative）. The clinical features were compared between the two groups. Results School-age children were significantly more in the experiment group than in the control group （ P 〈 0. 05 ）. Hyperthermia, CRP, Chest X-ray and/or CT ateleetasis and pleura] effusion were more serious in the experiment group than in the control group （ P 〈 0. 05 ）. There was no significant difference on bronchoseopic findings and BALF cytological classification between the two groups. Conclusion The clinical features of children with MPP are school-aged, hyperthermia, high expression of CRP, atelectasis, and pleural effusion. The positive MP-DNA can be easily detected in BALF, which may be associated with strong immune response. Appropriate extension of mac- rolide antibiotics therapy and immunization therapy should be useful.

关 键 词：肺炎支原体 肺炎 肺泡灌洗液 儿童 

分 类 号：R725.6[医药卫生—儿科]