肺炎支原体IgM抗体阳性出现时间与儿童支原体肺炎临床表现的相关性分析  

Correlation between the time of mycoplasma pneumoniae IgM antibody positive and clinical manifestations of mycoplasma pneumonia in children

作　　者：沈春燕[1] 傅晓燕[1] 桂明珠 陈峰 谢晓恬[2] SHEN Chunyan;FU Xiaoyan;GUI Mingzhu;CHEN Feng;XIE Xiaotian(Department of Pediatrics,Luodian Hospital,Baoshan District,Shanghai 201908,China;Department of Pediatrics,Shanghai Tongji Hospital,Shanghai 200065,China)

机构地区：[1]上海市宝山区罗店医院儿科,上海201908 [2]上海市同济医院儿科,上海200065

出　　处：《世界临床药物》2021年第2期113-118,共6页World Clinical Drug

基　　金：上海市宝山区科学技术委员会科研项目(19-E-52)。

摘　　要：目的探索肺炎支原体(mycoplasma pneumoniae,MP)-IgM抗体阳性出现时间与儿童肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)的临床表现和疗效转归的相关性。方法收集2017年1月至2019年12月于上海市宝山区罗店医院儿科就诊的MPP患儿224例的临床资料,对比分析MP-IgM抗体阳性结果在病程中的出现时间与MPP患儿临床表现的关联性。结果排除临床无发热症状者,本研究共纳入217例MPP患儿。按MP-IgM抗体阳性结果在病程中的出现时间,将所有患儿分为≤5 d组(n=112)和>5 d组(n=105)。两组患儿在年龄、性别分布、最高体温、发热持续时间及合并喘息例数等方面差异有统计学意义(P<0.05)。>5 d组的外周血细胞三系水平均高于≤5 d组(P<0.05)。两组C反应蛋白水平、影像学显示炎症范围及肝功能各项主要指标等差异均无统计学意义(P>0.05)。≤5 d组和>5 d组的重症肺炎发生率及总有效率差异无统计学意义(P>0.05)。>5 d组的阿奇霉素疗程、病程中位数高于≤5 d组(P<0.05)。>5 d组总病程中10 d及14 d以上的的患儿占比均高于≤5 d组(P<0.05)。经Logistic回归分析法结果显示,MPP患儿某些临床要素,如最高体温、总疗程和总病程等,与MP-IgM阳性出现时间密切相关(P<0.05),亦提示抗体出现阳性时间较晚者,总病程可能较长(P<0.05)。结论儿童支原体感染时,MP-IgM抗体阳性出现时间与患儿性别分布、外周血细胞计数,临床表现及阿奇霉素疗程和总病程等相关,可为临床诊治儿童MPP和疗效预测,以及后续研究等提供参考依据。Objective To explore the correlation between the time of mycoplasma pneumoniae(MP)-IgM antibody positive and the clinical manifestations and curative effect of children with mycoplasma pneumoniae pneumonia(MPP).Methods Clinical data of 224 children with MPP from January 2017 to December 2019 in Shanghai Luodian Hospital of Baoshan District were collected,to compare and analyze the correlation between the appearance time of MP-IgM antibody positive results in the course of disease and the clinical manifestations of children with MPP.Results Excluding those without fever,217 cases of MPP were included in this study.According to the occurrence time of MP-IgM antibody positive results in the course of disease,all children were divided into ≤ 5 d group(n=112) and >5 d group(n=105).There were significant differences in age,gender distribution,maximum body temperature,duration of fever and the number of cases with wheezing between the two groups(P<0.05).The level of three lineage of peripheral blood cells in the group of > 5 d was higher than that in the group of ≤ 5 d(P<0.05).There was no significant difference in C-reactive protein level,inflammatory range and liver function between the two groups(P>0.05).There was no significant difference in the incidence of severe pneumonia between the two groups(P>0.05).The median course of treatment and course of azithromycin in the group of >5 d was higher than that in the group of ≤ 5 d(P<0.05).The proportion of children with total course of disease >10 d and >14 din the >5 d group was higher than that in the ≤ 5 d group(P<0.05).Multiple regression analysis showed that gender distribution,maximum body temperature,three lineage blood cells and the total course of disease were independent related factors of the two groups.The highest body temperature was lower than the ≤ 5 d group,but the white blood cell count and neutrophil absolute value were higher than those of ≤ 5 d group,and the total course of disease was significantly longer than that of ≤ 5 d group(P<0.05)

关 键 词：肺炎支原体肺炎 肺炎支原体抗体 疗效转归 

分 类 号：R375.2[医药卫生—病原生物学] R563.19[医药卫生—基础医学]