以肺外表现为首发症状的107例肺炎支原体感染患儿临床分析  

Clinical Analysis of 107 Cases of Mycoplasma Pneumoniae Infection with Extrapulmonary Manifestations as the First Symptoms

作　　者：钟华[1] 徐小红[1] 潘凤娟[1] 田小华[1] 刘绘 ZHONG hua;XU Xiaohong;PAN Fengjuan;TIAN Xiaohua;LIU Hui(Guangdong Agricultural Reclamation Center Hospital,Zhanjiang 524002,China)

机构地区：[1]广东省农垦中心医院,广东湛江524002

出　　处：《沈阳医学院学报》2018年第4期323-325,328,共4页Journal of Shenyang Medical College

摘　　要：目的:分析以肺外表现为首发症状的肺炎支原体(MP)感染患儿的临床表现、肺外并发症及转归。方法:回顾性分析我院2016年4月至2017年6月门诊和住院收治的154例MP感染患儿情况,107例以肺外表现为首发症状患儿为肺外组,47例以肺部表现为首发症状的患儿为肺内组,观察肺外首发症状构成情况,比较2组MP感染确诊时间、开始使用大环内酯类抗生素时间和平均病程。结果:肺外组首发症状以消化系统症状最多,占42.99%;其次是血液系统和心血管系统,分别占14.02%和13.08%;神经系统症状占8.41%,泌尿系统症状占5.61%,皮肤及关节症状占1.87%,另有14.02%的患儿伴多系统症状。肺外组MP感染确诊时间和开始使用大环内酯类抗生素时间较肺内组长,差异有统计学意义(P<0.05)。肺外组平均病程略长于肺内组,但差异无统计学意义(P>0.05)。结论:MP感染患儿肺外表现呈多样性,以消化系统症状居多,易误诊误治。在对症治疗效果不佳时应考虑MP感染的可能性,及时进行检查并治疗。Objective:To analyze the clinical manifestation,extrapulmonary complications and prognosis of patients with mycoplasma pneumoniae(MP)infection with extrapulmonary manifestations as the first symptom.Methods:A total of 154 cases of children with MP infection from Apr 2016 to Jun 2017 in our hospital were selected as objects,and were divided into two groups,extrapulmonary group(107 cases)with extrapulmonary manifestations as the first symptoms and intrapulmonary group(47 cases)with pulmonary manifestations as the first symptoms.Extrapulmonary manifestations were observed.The diagnosis time of MP infection,the time to start using macrolide antibiotics,and the average course of disease were compared between the two groups.Results:The most common extrapulmonary symptoms were digestive symptoms,which accounted for 42.99%,followed by the hematological and cardiovascular systems,which accounted for 14.02%and 13.08%,respectively.Neurological symptoms accounted for 8.41%,urinary symptoms accounted for 5.61%,and skin and joint symptoms accounted for 1.87%,and another 14.02%of children with multiple systemic symptoms.The diagnosis time of MP infection and the time to start using macrolide antibiotics in the extrapulmonary group were significantly longer than thoes in the intrapulmonary group(P<0.05).The average course of the extrapulmonary group was longer than that of the intrapulmonary group,but the difference was not statistically significant(P>0.05).Conclusions:The extrapulmonary manifestations of children with MP infection are diversity,and most of them are digestive system symptoms,which are easily misdiagnosed and mistreated.When symptomatic treatment is not effective,the possibility of MP infection should be considered,and examination and treatment should be conducted in time.

关 键 词：肺炎支原体 肺外表现 首发症状 

分 类 号：R725.6[医药卫生—儿科]