特应性体质肺炎支原体肺炎患儿的临床特点分析  

Clinical characteristics of children with atopic mycoplasma pneumoniae pneumonia

作　　者：姚慧生[1] 刘立云[1] 伊丽丽[1] 韩丽娜[1] 周倩兰[1] 李淼[1] 韩晓华[1] Yao Huisheng;Liu Liyun;Yi Lili;Han Lina;Zhou Qianlan;Li Miao;Han Xiaohua(Department of Respiratory Pediatrics,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院小儿呼吸内科,沈阳110004

出　　处：《国际儿科学杂志》2020年第9期652-657,共6页International Journal of Pediatrics

摘　　要：目的:探讨特应性体质肺炎支原体肺炎患儿的临床特点,为特应性体质肺炎支原体肺炎患儿的诊疗提供依据。方法:选取2018年1月至2018年12月于中国医科大学附属盛京医院确诊为肺炎支原体肺炎的患儿180例,按照是否为特应性体质,分为特应性体质肺炎支原体肺炎(atopic mycoplasma pneumoniae pneumonia,AMPP)组(84例),非特应性体质肺炎支原体肺炎(non-atopic mycoplasma pneumoniae pneumonia,NAMPP)组(96例);统计两组患儿年龄、性别、发热时间、住院时间、大环内酯类药物应用时间、白细胞、CRP、乳酸脱氢酶(LDH)、肺CT等临床资料,回顾性总结分析并比较两组患儿的临床表现、实验室检查及影像学表现的差异。结果:(1)AMPP组嗜酸性粒细胞绝对值、总免疫球蛋白E(immunoglobulin E,IgE)数值均高于NAMPP组,差异有统计学意义(P<0.05),AMPP组重症肺炎支原体肺炎(severe mycoplasma pneumoniae pneumonia,SMPP)和(或)难治性肺炎支原体肺炎(refractory mycoplasma pneumoniae pneumonia,RMPP)及胸部影像表现为间质性肺炎改变的发生率更高,差异有统计学意义(P<0.05)。(2)AMPP组发生喘息患儿占48.81%(41例/84例),显著高于NAMPP组发生喘息患儿的22.92%(22例/96例),AMPP组患儿咳嗽及喘息时间长于NAMPP组,差异有统计学意义(P<0.05),其余如发热时间、热退时间及大环内酯类药物应用时间方面差异无统计学意义。(3)AMPP组中有36.90%(31例/84例)的患儿静脉应用糖皮质激素治疗,明显高于NAMPP组的20.83%(20例/96例)。肺部啰音吸收的时间AMPP组[(9.73±3.59)d]明显长于NAMPP组[(7.52±2.44)d],差异有统计学意义(P<0.05)。复查肺CT,AMPP组肺部炎症吸收较NAMPP组差,差异有统计学意义(P<0.05),AMPP组患儿住院时间[(10.88±4.17)d]长于NAMPP组[(9.68±2.68)d],差异有统计学意义(P<0.05)。结论:AMPP患儿较NAMPP患儿病情严重,更容易出现肺部炎症的不完全吸收,临床应给予重视。Objective To explore the clinical characteristics of children with atopic mycoplasma pneumoniae pneumonia and to provide evidence for the diagnosis and treatment of children with atopic mycoplasma pneumoniae pneumonia.Methods One hundred and eighty cases of children diagnosed with mycoplasma pneumoniae pneumonia in Shengjing Hospital of China Medical University from January 2018 to December 2018 were selected.According to whether they had atopic constitution,they were divided into atopic mycoplasma pneumoniae pneumonia(AMPP)group(84 cases)and non-atopic mycoplasma pneumoniae pneumonia(NAMPP)group(96 cases).The clinical data of age,sex,fever time,hospital stay,application time of macrolides,white blood cells,CRP,LDH,and lung CT were collected from the two groups,and the differences in clinical manifestations,laboratory examinations and imaging manifestations of the two groups were analyzed retrospectively.Results(1)Both the absolute value of eosinophils and total IgE values in the AMPP group were higher than those in the NAMPP group,and the difference was statistically significant(P<0.05).The incidence of severe mycoplasma pneumoniae pneumonia(SMPP)and/or refractory mycoplasma pneumoniae pneumonia(RMPP)and chest imaging manifestations of interstitial pneumonia in the AMPP group was higher,and the difference was statistically significant(P<0.05).(2)The incidence of wheezing in the AMPP group was 48.81%(41 cases/84 cases),which was significantly higher than that in the NAMPP group 22.92%(22 cases/96 cases).The duration of cough and wheezing in the AMPP group was longer than that in the NAMPP group(P<0.05),with statistically significant differences(P<0.05).(3)In the AMPP group,36.90%(31 cases/84 cases)of the children received intravenous methylprednisolone treatment,which was significantly higher than the 20.83%(20cases/96 cases)of the NAMPP group.Lung rales absorption time in the AMPP group[(9.73±3.59)d]was significantly longer than that in the NAMPP group[(7.52±2.44)d],and the difference was statistically signifi

关 键 词：儿童 肺炎支原体肺炎 特应性体质 喘息 

分 类 号：R725.6[医药卫生—儿科]