儿童难治性肺炎支原体肺炎肺功能的变化规律及临床意义  

Change regularity and clinical significance of pulmonary function in children with refractory Mycoplasma pneumoniae pneumonia

作　　者：周彩丽[1] 贾云乔 刘宗伟[1] 段全纪[3] 

机构地区：[1]潍坊医学院,山东潍坊261053 [2]石家庄市第五医院,河北石家庄050024 [3]潍坊市人民医院,山东潍坊261000

出　　处：《中国妇幼保健》2016年第19期3952-3955,共4页Maternal and Child Health Care of China

基　　金：山东省医药卫生科技发展计划项目(2015WS0084);潍坊市科学技术发展计划项目合同书;潍坊医学院"健康山东"重大社会风险预测与治理协同创新中心;健康领域社会风险预测与治理协同创新中心课题资助(XT1406002)

摘　　要：目的观察难治性肺炎支原体肺炎(RMPP)患儿肺功能的变化特点,从而进一步了解肺部病理情况,有利于临床诊疗及预后判断。方法回顾性分析2014年12月-2015年12月该院儿科住院治疗的160例肺炎支原体肺炎(MPP)患儿,将其分为RMPP组58例、轻症肺炎支原体肺炎(MMPP)组102例,所有患儿均在发病第3天及发病第14天行肺通气功能检查,将各组指标进行统计学分析。结果 RMPP组患儿在发病第3天行肺通气功能检查,代表大气道通气功能的指标[用力肺活量(FVC)、第一秒用力呼气容积(FEV1)、呼气峰流速(PEF)]及代表小气道通气功能的指标[最大中段呼气流速(MMEF 25-75)、25%肺活量位的最大呼气流速(MEF25)、50%肺活量位的最大呼气流速(MEF50)]与MMPP组患儿相比,各项指标均明显降低,差异具有统计学意义(t=-3.078、-4.654、-0.322、-4.359、-3.932和-4.283,均P<0.05);RMPP组患儿发病第14天时行肺通气功能检查,代表大气道通气功能的指标(FVC、FEV1、PEF)及代表小气道通气功能的指标(MMEF25-75、MEF25、MEF50)均低于MMPP组,差异具有统计学意义(t=-3.619、-6.425、-7.731、-7.602、-6.835和-8.357,均P<0.05);与发病第3天肺功能指标比较,RMPP组及MMPP组患儿在发病第14天所行肺功能指标均有不同程度升高,差异具有统计学意义(t=-4.846、-10.694、-6.405、-16.282、-12.076和-13.702;-3.102、-13.127、-15.559、-20.470、-14.614和-19.076,均P<0.05)。结论 RMPP患儿易出现更为严重的混合性通气功能障碍,主要为轻中度限制性通气功能障碍及重度阻塞性通气功能障碍,经有效治疗后,肺功能受损情况可逐渐恢复正常,远期预后良好。Objective To observe the change characteristics of pulmonary function in children with refractory Mycoplasma pneumoniae pneumonia （RMPP）, further understand lung pathological situations, provide a basis for clinical diagnosis, treatment and prognosis judge- ment. Methods A total of 160 hospitalized children with Mycoplasma pneumoniae pneumonia （MPP） from Department of Pediatrics in the hospital from December 2014 to December 2015 were analyzed retrospectively. The children were divided into RMPP group （58 children） and mild MPP （MMPP） group （102 children） . Pulmonary ventilation function was examined on the third day and the fifteenth day after on- set of the disease among all the children. The indexes in different groups were analyzed statistically. Results FVC, FEV1, PEF, MMEF 25-75, MEF25, MEF50 on the third day in RMPP group were statistically significantly lower than those in MMPP group （t =- 3. 078, -4. 654, -0. 322, -4. 359, -3. 932, -4. 283, P〈0. 05） . FVC, FEV1, PEF, MMEF25-75, MEF25, MEF50 on the fourteenth day in RMPP group were statistically significantly lower than those in MMPP group （t = -3. 619, -6. 425, -7. 731, -7. 602, -6. 835, -8. 357, P〈0. 05） . The parameters on the fourteenth day in the two groups were statistically significantly higher than those on the third day （ t = - 4. 846, -10. 694, -6. 405, -16. 282, -12. 076, -13. 702, P〈0. 05; -3. 102, -13. 127, -15. 559, -20. 470, -14. 614, -19. 076, P〈 0. 05 ） . Conclusion Mixed ventilation dysfunction is more serious in RMPP children, mild-to-moderate restrictive ventilation dysfunction and severe obstructive ventilation dysfunction are the main types ; after effective treatment, pulmonary function damage can gradually return to normal, the long-term prognosis is good.

关 键 词：难治性肺炎支原体肺炎 肺功能 变化规律 儿童 

分 类 号：R563.1[医药卫生—呼吸系统]