儿童肺炎支原体肺炎合并胸腔积液的临床特征及实验室检查结果分析  

Analysis of clinical characteristics and laboratory examination results of children with MPP complicated with PE

作　　者：王喆[1] 李玉琴[1] 骆亚丽[1] 丁莹[1] 储矗[1] 周卫芳[1] 

机构地区：[1]苏州大学附属儿童医院,苏州215003

出　　处：《右江医学》2017年第5期539-543,共5页Chinese Youjiang Medical Journal

基　　金：苏州市科技计划项目(SS201535)

摘　　要：目的探讨并比较儿童肺炎支原体肺炎(MPP)及MPP合并胸腔积液(PE)的临床及实验室检查特征,为临床诊治提供依据。方法回顾性分析2015年1月至2016年12月住院的MPP患儿共774例,分为单纯MPP组716例及MPP合并PE组58例,收集临床及实验室检查资料并分析。结果单纯MPP组平均年龄为(3.17±2.66)岁,MPP合并PE组平均年龄为(5.10±2.55)岁,差异有统计学意义(P<0.05),后者学龄期儿童比例占41.4%,差异有统计学意义(P<0.05)。MPP合并PE组的热程及住院时间均长于单纯MPP组,差异有统计学意义(P<0.01)。MPP合并PE组多为以肺实变为主的大叶性肺炎(82.8%),高于单纯MPP组(22.5%),差异有统计学意义(P<0.01)。MPP合并PE组的CRP及LDH值均高于单纯MPP组,差异有统计学意义(P<0.05)。MPP合并PE组的CD3+、CD3+CD4+T淋巴细胞比例和CD4+/CD8+比值均低于单纯MPP组(P<0.01),而CD3+CD8+T淋巴细胞比例则高于后者(P<0.01)。MPP合并PE组的Ig A值高于单纯MPP组(P<0.05),而Ig M、Ig G值两组间差异无统计学意义。结论MPP合并胸腔积液时患儿的临床特征及实验室检查结果与单纯MPP患儿存在明显差异,证实MPP并发胸腔积液时存在更为严重的免疫损伤。Objective To explore and compare the clinical characteristics and laboratory examination results of children with MPP（ mycoplasma pneumoniae pneumonia） complicated with PE（ pleural effusion）,so as to provide basis for clinical diagnosis and treatment.Methods 774 children hospitalized in hospital during January,2015 to December,2016 were analyzed retrospectively.All patients were divided into MPP group（ n = 716） and MPP ＋PE group（ n = 58）.Clinical data and laboratory results were collected and analyzed.Results The average age of the MPP group was（ 3.17±2.66） year,and that of the MPP ＋PE group was（ 5. 10 ± 2. 55） year,difference was statistically significant（ P 〈 0. 05）. The proportion of school-age children in MPP ＋PE group accounted for 41.4%,difference was statistically significant（ P〈0.05）. The duration of fever and hospitalization of the MPP ＋PE group was longer than that of the MPP group,difference was statistically significant（ P〈0.01）.The MPP＋PE group were mainly lobar pneumonia with pulmonary consolidation（ 82.8%）,which was significantly higher than that of the MPP group（ 22.5%）,difference was statistically significant（ P〈0.01）. The CRP and LDH values of the MPP ＋PE group were higher than those of the MPP group,difference was statistically significant（ P 〈 0.05）. The CD3＋,CD3＋CD4＋T lymphocyte ratio and CD4＋/CD8＋ratio of the MPP ＋PE group were lower than those of the MPP group（ P〈0.01）,while the proportion of CD3＋CD8＋T lymphocytes was higher than that of the latter（ P〈0.01）.The Ig A value of the MPP ＋PE group was significantly higher than that of the MPP group（ P〈0.05）,but there was no statistically significant difference between Ig M and Ig G values in the two groups.Conclusion There is significantly statistical difference in clinical characteristics and laboratory examination results between the two groups,which confirms that MPP combined with PE has more severe immune damage.

关 键 词：肺炎支原体 肺炎 胸腔积液 儿童 

分 类 号：R725.6[医药卫生—儿科]