儿童肺炎支原体肺炎200例临床特征分析  

Analysis of Clinical Features of 200 Pediatric Patients with Mycoplasma Pneumonia

作　　者：余韶卫[1] 

机构地区：[1]广东省广州市红十字会医院暨南大学医学院第四附属医院儿内科,广东广州510220

出　　处：《医学临床研究》2013年第10期1907-1909,共3页Journal of Clinical Research

摘　　要：【目的】探讨儿童肺炎支原体肺炎（MPP）的临床特点以及肺外并发症的表现，为MPP患儿的-临床诊断及治疗提供依据。【方法】选取本院2010年1月至2013年1月收治的MPP患儿200侧为研究对象，回顾性分析患儿的临床资料、并发症发生情况及转归情况，选取普通上呼吸道感染患儿100例为对照1组，同时选取100例正常体检儿童为对照2组，对比分析三组儿童血清白细胞介素-6（IL-6）、白细胞介素-17（IL-17）、肿瘤坏死因子-α（TNF-α）的变化情况。【结果】MPP患儿患病年龄0-2岁32例（16．00％），3～6岁88例（44．00％），7～10岁48例（24．00％），11～13岁32例（16．00％）。MPP患儿肺外并发症主要为心肌缺血45例（22．5％）、神经系统疾病22例（11．0％）、肝肾损害15例（7．5％）、皮肤黏膜损害10例（5．0％）以及消化系统损害9例（4．50％）。MPP组患儿血清中IL6、IL-17、TNF-α水平显著高于对照1组及对照2组，两两对比差异有显著性（PdO．05）。MPP患儿药敏实验结果证实对阿奇霉素敏感性好，未出现耐药情况，所有患儿均治愈出院。【结论】MPP主要以学龄儿童为主，患儿临床表现为多系统性器官损害。IL-6、IL-17、TNF-α等炎症因子水平的上升可能是导致MPP发生的重要因素，通过测定患儿炎症因子水平能有效对患儿病情做出诊断。[Objective] To explore clinical features of pediatric patients with mycoplasma pneumoniae pneumonia（MPP） and manifestations of extrapulmonary complications so as to provide the basis for clinical diagnosis and treatment of pediatric patients with MPP. [Methods]Totally 200 pediatric patients with MPP in our hospital from Jan. 2010 to Jan. 2013 were enrolled in the study. Clinical data, the incidence of complications and the prognosis of patients were analyzed by regression method. Other 100 pediatric patients with common upper respiratory infection were selected as control group 1. Meanwhile 100 normal children were selected as control group 2. The changes of interleukin-6（IL 6）, interleukin-17（IL-17） and tumor necrosis factor-alpha（TNF-α）in serum of 3 groups were analyzed and compared. [ResultslThe age of pediatric patients with MPP was 0 ~ 2 years old in 32 cases （16%）, 3~6 years old in 88 cases （44%）, 7~10 years old in 48 cases（24%）, 11~13 years old in 32 cases （16 %）. Extrapulmonary complications of pediatric patients with MPP were mainly myocardial ischemia in 45 cases （22.5%）, nervous system diseases in 22 cases（11%）, liver and kidney damage in 15 cases（7.5%）, skin and mucosal lesions in 10 cases（5%） and digestive system injury in 9 cases（4. 50%）. Serum levels of IL-6, IL-17 and TNF-α in MPP group were markedlyhigher than those in control group 1 and control group 2, and there were significant differences between two groups（ P 〈0. 05）. Drug sensitive test results of pediatric patients with MPP confirmed that the resistance to azithromycin was better and there was no drug resistance. All pediatric patients were cured and discharged. [Conclusion]MPP mainly occurs in school age children. The major clinical manifestation is multiple system organ damage. The increasing of inflammatory cytokines such as IL-6, IL-17 and TNF-α may he important factors which lead to the occurrence of MPP. The detection of inflammatory cytokines can effectively make the d

关 键 词：肺炎 支原体 

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