肺炎支原体感染支气管肺炎与大叶性肺炎患儿的肺CT特征及临床特征比较  

Comparison of pulmonary CT features and clinical features between mycoplasma pneumoniae infected children with bronchopneumonia and lobar pneumonia

作　　者：邹红华 ZOU Honghua(Ganzhou Maternal and Child Health Hospital,Ganzhou,Jiangxi,341000,China)

机构地区：[1]赣州市妇幼保健院,江西赣州341000

出　　处：《当代医学》2024年第18期65-69,共5页Contemporary Medicine

摘　　要：目的比较肺炎支原体(mycoplasma pneumoniae,MP)感染所致支气管肺炎与大叶性肺炎患儿的肺CT特征、临床特征及实验室检查指标、肺功能指标。方法回顾性分析2023年1月至2024年1月赣州市妇幼保健院收治的88例肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)患儿的临床资料,依据肺部影像学检查结果分为支气管肺炎组(n=48)和大叶性肺炎组(n=40)。两组均行肺部CT检查及血常规、炎症感染、免疫功能、肺功能指标检测,比较两组肺部CT特征、临床症状、血常规指标、炎症感染指标、免疫功能指标、肺功能指标。结果肺部CT特征:支气管肺炎组25例患儿出现斑片影,其中右侧肺18例,左侧肺17例,肺实质内可见小斑片密度增高影;23例患儿出现实变影,其中右侧肺12例,左侧肺11例,可见支气管的气相影像,但边缘不清晰。大叶性肺炎组13例处于渗出期,病变周边呈模糊云雾状影,病灶区透明度降低为磨玻璃样影;20例处于实变期,显示为肺叶、肺段实变导致具有一致均匀性高密度影,实变部位一般为大叶性或占据大叶大部分,其中5例出现空气支气管征象;7例处在消散期,呈斑片状阴影。其中36例为单肺受累,4例为双肺受累。大叶性肺炎组年龄<5岁占比、喘息发生率均低于支气管肺炎组,发热、胸腔积液发生率均高于支气管肺炎组,发热时间、住院时间均长于支气管肺炎组,差异有统计学意义(P<0.05)。大叶性肺炎组白细胞计数、中性粒细胞比率、嗜酸性粒细胞百分比、血小板计数均高于支气管肺炎组,淋巴细胞百分比低于支气管肺炎组,差异有统计学意义(P<0.05)。大叶性肺炎组血清C反应蛋白、降钙素、血清淀粉样蛋白A及天门冬氨酸氨基转移酶水平均高于支气管肺炎组,差异有统计学意义(P<0.05)。大叶性肺炎组CD3^(+)、CD3^(+)/CD8^(+)、IgA水平均高于支气管肺炎组,CD4^(+)/CD8^(+)低于支气管肺炎组,差异Objective To compare the CT features,clinical features,laboratory examination indicators and lung function indexes of children with bronchopneumonia and lobar pneumonia caused by mycoplasma pneumoniae(MP)infection.Methods The clinical data of 88 mycoplasma pneumoniae pneumonia(MPP)children admitted to Ganzhou Maternal and Child Health Hospital were retrospectively analyzed,they were divided into the bronchopneumonia group(n=48)and the lobar pneumonia group(n=40)according to the results of lung imaging.Lung CT examination andblood routine examination,inflammation and infection,immune function,lung function index detection were performed in the two groups.The CT features,clinical symptoms,blood routine indexes,inflammation and infection indexes,immune function indexes and lung function indexes were compared between the two groups.Results CT features of the lungs:25 children in the bronchopneumonia group showed patchy shadows,18 cases in the right lung and 17 cases in the left lung,with small patches of increased density in the lung parenchyma;23 children showed consolidation,12 cases in the right lung and 11 cases in the left lung,the gas phase image of the bronchus was visible,but the edge was not clear.In the lobar pneumonia group,13 cases were in exudative stage,the periphery of the lesion presented vague cloud like shadow,and the transparency of the lesion area decreased to ground glass like shadow;20 cases were in consolidation stage,it showed that the consolidation of lung lobes and segments results in a uniform but high-density image,and the consolidation site was generally lobar or occupies a large part of lobar,5 cases showed signs of air bronchus;7 cases were in the dissipative phase,showing patchy shadows.Among them,36 cases were involved in one lung and 4 cases were involved in both lungs.The proportion of age<5 years and the incidence of wheezing in the lobar pneumonia group were lower than those in the bronchopneumonia group,the incidence of fever and pleural effusion were higher than those in the bro

关 键 词：肺炎支原体 支气管肺炎 大叶性肺炎 

分 类 号：R725.6[医药卫生—儿科]