混合腺病毒感染对肺炎支原体肺炎合并胸腔积液患儿的影响  

Effects of adenovirus mixed infection on children with Mycoplasma pneumoniae pneumonia complicated with pleural effusion

作　　者：吴佩[1] 曾赛珍 黄倩[1] 谌艳梅 刘淑琼 王小顺 谢乐云[1] 余阗 Wu Pei;Zeng Saizhen;Huang Qian;Shen Yanmei;Liu Shuqiong;Wang Xiaoshun;Xie Leyun;Yu Tian(Pediatric Medical Center,the First Affiliated Hospital of Hunan Normal University(Hunan Provincial People′s Hospital),Changsha 410005,China)

机构地区：[1]湖南师范大学附属第一医院湖南省人民医院儿童医学中心,长沙410005

出　　处：《中国小儿急救医学》2022年第12期968-972,共5页Chinese Pediatric Emergency Medicine

基　　金：湖南省儿童呼吸疾病重点实验室项目(2019TP1043)。

摘　　要：目的总结肺炎支原体肺炎(MPP)合并胸腔积液患儿的临床特点,探讨混合腺病毒感染对其预后的影响。方法回顾性分析2013年1月至2019年12月湖南师范大学附属第一医院(湖南省人民医院)儿童医学中心确诊为MPP合并胸腔积液患儿的临床资料,按是否混合腺病毒感染分为单一感染组及混合感染组,比较两组的临床资料。结果共纳入180例MPP合并胸腔积液患儿,男女比例1.22∶1(99/81),年龄66.13(44.35,83.98)个月,以5岁以上儿童最为常见(55.56%),住院时间为9.00(7.00,12.00)d。临床表现以发热(93.33%)、咳嗽(98.33%)最为常见,实验室检查以C-反应蛋白、红细胞沉降率、D-二聚体轻度升高多见。纳入患儿以右侧胸腔积液多见(54.44%),双侧胸腔积液占26.67%,左侧胸腔积液占18.89%。与单一感染组相比,混合感染组住院时间更长,需吸氧比例及丙种球蛋白使用比例更高,乳酸脱氢酶、谷草转氨酶值更高;但多因素Logistic回归分析结果显示,相对单一感染组,混合感染组仅丙种球蛋白使用比例更高(36.54%比10.93%,P<0.05),住院时间、临床表现、实验室检查、胸部CT及纤维支气管镜下表现,两组之间均差异无统计学意义。结论MPP合并胸腔积液多见于5岁以上儿童,以右侧最为常见,C-反应蛋白、红细胞沉降率、D-二聚体轻度升高多见。MPP合并胸腔积液混合腺病毒感染与单一感染患儿临床特征相似。Objective To summarize the clinical characteristics of children with Mycoplasma pneumoniae pneumonia(MPP)complicated with pleural effusion,and explore the effect of mixed adenovirus infection on children with MPP complicated with pleural effusion.Methods The clinical data of children with MPP complicated with pleural effusion diagnosed in Children′s Medical Center at the First Affiliated Hospital of Hunan Normal University(Hunan Provincial People′s Hospital)from January 2013 to December 2019 were collected.MPP cases were divided into single infection group and mixed infection group according to whether mixing adenovirus infection.The clinical characteristics were compared between two groups.Results A total of 180 children with MPP complicated with pleural effusion were included,the male to female ratio was 1.22∶1(99/81),the age was 66.13(44.35,83.98)months,and the most common cases were children over 5 years old(55.56%).The length of hospitalization was 9.00(7.00,12.00)days.Fever(93.33%)and cough(98.33%)were the most common clinical manifestations,and mild increases in C-reactive protein,erythrocyte sedimentation rate and D-dimer were the most common laboratory results.Among included children,right pleural effusion was the most common(54.44%),bilateral pleural effusion accounted for 26.67%,and left pleural effusion accounted for 18.89%.Compared with single infection group,the mixed infection group had a longer hospital stay,a higher proportion of oxygen intake,a higher proportion of gamma globulin use,and a higher value of lactate dehydrogenase and aspartate aminotransferase.The results of multivariate Logistic regression analysis showed that compared with single infection group,although the mixed infection group had a higher proportion of gamma globulin use(36.54%vs.10.93%,P<0.05),the length of hospital stay,clinical manifestations,laboratory examination,chest CT and fiberoptic bronchoscopy showed no statistically significant difference between two groups.Conclusion MPP complicated with pleural effusion is

关 键 词：肺炎支原体肺炎 胸腔积液 腺病毒感染 儿童 

分 类 号：R725.6[医药卫生—儿科]