苏州地区婴幼儿肺炎支原体肺炎住院患儿流行病学及临床特点分析  

Epidemiology and cfinical characteristics of Mycoplasma pneumoniae pneumonia in hospitalized children younger than three year-old

作　　者：许秋艳 范丽萍[2] 陶会[2] 孙惠泉[2] 郝创利 Xu Qiuyan Fan Liping Tao Hui Sun Huiquan Hao Chuangli(Department of Pediatrics, Suzhou Science And Technology Town Hospital, Suzhou 215153, China)

机构地区：[1]苏州科技城医院儿科,215153 [2]苏州大学附属儿童医院呼吸科,215003

出　　处：《中国小儿急救医学》2017年第3期215-219,共5页Chinese Pediatric Emergency Medicine

摘　　要：目的 探讨2009至2014年苏州市婴幼儿住院患儿肺炎支原体肺炎（Mycoplasma pneumoniae pneumonia，MPP）流行病学及临床特点。方法 选取2009年1月至2014年12月苏州大学附属儿童医院呼吸科住院的社区获得性肺炎（community-acquired pneumonia，CAP）婴幼儿患儿17 855例，其中MPP患儿1 145例，根据年龄分为1个月～1岁组（512例）、1～2岁组（393例）及2～3岁组（240例），对婴幼儿MPP的流行病学及不同年龄的临床特点、实验室检查及影像学资料进行分析。结果 （1）流行病学：苏州地区各个季节以秋季感染率（10.46%）最高，春季（3.46%）最低，不同年龄感染率以2～3岁组（11.61%）最高，差异均有统计学意义（P〈0.05）。（2）临床特点：与1个月～1岁组和1～2岁组相比，2～3岁组的发热人数（53.9%比77.1%比85.4%）及高热人数（16.8%比30.5%比41.4%）更多，热程（3 d比5 d比6 d）更长，而喘息人数（61.3%比52.4%比42.9%）及呼吸困难人数（7.6%比4.6%比3.8%）更少，差异均有统计学意义（P均〈0.05）。（3）实验室检查：不同年龄中性粒细胞百分数、淋巴细胞百分数、CRP及血小板计数，差异均有统计学意义（P均〈0.001）。（4）影像学检查：2～3岁组MPP患儿肺部出现大片状阴影（64例，26.7%）较1～2岁组（78例，19.8%）及1个月～1岁组（38例，7.4%）更多，且出现胸腔积液者（5.4%比3.3%比1.0%）更多，差异均有统计学意义（P均〈0.001）。结论 MP是婴幼儿呼吸道感染的重要病原菌，年龄越大越易感染MP，MPP各个季节均可发病，其中苏州地区以秋季高发、夏季次之。年龄越大的MPP患儿发热人数及高热人数越多、热峰越长，年龄越小越易合并病毒感染，越易出现呼吸困难。MPP婴幼儿肺部影像学改变以小斑片状影改变为主，年龄越大，越易出现肺部大片状阴影、胸腔积液。Objective To summarize the epidemiology and evaluate possible age-related differences in the presenting clinical features in three year-old children with Mycoplasma pneumoniae pneumonia（MPP）during 2009 to 2014.Methods The medical records of 17 855 children with community-acquired pneumonia enrolled by Children′s Hospital of Soochow University during 2009 to 2014.Totally 1 145 younger than three year-old children with MPP were enrolled, and they were classified into three groups of 1 month to 1 year-old group （n=512）, 1 to 2 year-old group （n=393） and 2 to 3 year-old group （n=240）. The epidemiology and possible age-related differences in the presenting clinical features, main laboratory and imaging results in three year-old children with MPP were summarized.Results （1） The highest infection rate of different reasons in Suzhou was in autumn（10.46%）, and the lowest was in spring（6.95%）, The highest infection rate of different ages was 2 to 3 year-old group（11.61%）, and the difference was statistically significant （P〈0.05）. （2） Compared with 1 month to 1 year-old group（n=512, 4.31%） and 1 to 2 year-old group （n=39, 10.09%）, 2 to 3 year-old group （n=240, 11.61%） had higher infection rate, more patients with fever（53.9% vs. 77.1% vs. 85.4%） and high fever（16.8% vs. 30.5% vs. 41.4%）, longer time to normalization of temperature（3 d vs. 5 d vs. 6 d）, but less patients with wheezing（61.3% vs. 52.4% vs. 42.9%） and dyspnea（7.6% vs. 4.6% vs. 3.8%）. （3） The differences were statistically significant in the percentage of neutrophils, lymphocytes, CRP and platelet count between different ages（P〈0.001）. （4） The incidences of large area of lesions in chest X-ray examination among different ages had significant differences（P〈0.001）.Conclusions MP is one of the important pathogens of respiratory tract infection in younger than 3 year-old children.It can occur in every season, and the highest infection rate of MP is in autumn and spring.In

关 键 词：肺炎支原体 肺炎 临床特点 

分 类 号：R725.6[医药卫生—儿科]