儿童支原体肺炎与肺炎链球菌性肺炎的CT表现及鉴别诊断  

CT findings and differential diagnosis of Streptococcus pneumonia and Mycoplasma pneumonia in children

作　　者：王淑英[1] 牟月芝[1] 李宏伟[1] 王雪峰[1] 

机构地区：[1]齐齐哈尔医学院附属第三医院放射科,黑龙江齐齐哈尔161000

出　　处：《中华医院感染学杂志》2015年第13期3092-3093,3098,共3页Chinese Journal of Nosocomiology

基　　金：黑龙江省卫生厅规划基金资助项目(HW-2012B-029)

摘　　要：目的探讨儿童支原体肺炎与支原体肺炎合并肺炎链球菌(SPN)性肺炎的影像学表现差异及临床鉴别诊断,为临床早期鉴别诊断与治疗提供参考。方法选取2005年1月-2010年3月就诊并确诊的支原体肺炎(MP组)患儿35例和支原体肺炎合并肺炎链球菌性肺炎(MP+SPN组)患儿30例,分析两组患儿的CT图像;分别对病变分布、病变形态以及各种并发症进行鉴别诊断与统计分析。结果 MP组患儿病变部位为左肺上叶、左肺下叶、右肺上叶、右肺中叶及右肺下叶,其分布率分别为45.71%、37.14%、25.71%、37.14%及28.57%,MP+SPN组分别为33.33%、43.33%、33.33%、30.00%及36.67%,发病部位两组比较差异无统计学意义;病变形薄片影MP组比MP+SPN组高,无规律肺内实变影MP+SPN组比MP组高,两组差异有统计学意义(P<0.05);影像学比较,磨玻璃影、网状影、支气管壁增厚、支气管血管束增厚两组间差异均有统计学意义(P<0.05)。结论确定MP组与MP+SPN组患儿的影像学表现差异和临床鉴别诊断,为临床诊断提供了帮助。OBJECTIVE To investigate imaging manifestation differences and clinical differential diagnosis of Myco‐plasma pneumonia （MP） and MP complicated by Streptococcus pneumonia （SPN） in children ,so as to provide a reference for early clinical differential diagnosis and treatment .METHODS Totally 35 children with MP and 30 children with MP complicated by SPN admitted and confirmed during Jan .2005 to Mar .2010 were selected as the MP group and the MP＋SPN group .CT images were analyzed in the two groups .The lesion distribution ,patho‐morphology and complications were identified ,diagnosed and statistically analyzed respectively in the two groups . RESULTS The lesions appeared in the left upper lobe ,the left lower lobe ,the right upper lobe ,the right middle lobe and the right lower lobe ,accounting for 45 .71% ,37 .14% ,25 .71% ,37 .14% ,and 28 .57% in the MP group and 33 .33% ,43 .33% ,33 .33% ,30 .00% ,and 36 .67% in the MP＋ SP group .The difference in lesion site was not significant between the two groups .The lesion deformed thin shadow was greater in the MP group than in the MP＋SPN group ,however ,the irregular pulmonary consolidated shadow was greater in the MP＋SPN group than in the MP group ,the difference between the two groups was significant （P〈0 .05） .The imaging com‐parison showed that there were significant differences in ground‐glass opacity ,reticular opacities ,bronchial wall thickening ,and thickening of the bronchial vascular bundle between the two groups （P〈 0 .05） .CONCLUSION The identification of imaging manifestation differences and the clinical differential diagnosis of children in the MP group and the MP＋SPN group contributes to clinical diagnosis .

关 键 词：肺炎支原体 支原体肺炎 肺炎链球菌性肺炎 CT 鉴别诊断 

分 类 号：R563.1[医药卫生—呼吸系统]