基于呼吸道多种病原体靶向测序的儿童肺炎支原体肺炎病原学及临床特征分析  

Analysis of the etiology and clinical characterization of Mycoplasma pneumoniae pneumonia in children based on targeted next generation sequencing

作　　者：杨月 张宇翔 梁譞 杨辉[2] 齐静 张蓉芳[2] YANG Yue;ZHANG Yuxiang;LIANG Xuan;YANG Hui;QI Jing;ZHANG Rongfang(The First School Clinical Medical,Gansu University of Chinese Medicine,Gansu Province,Lanzhou 730000,China;Department of Allergy,Gansu Provincial Maternal and Child Health Hospital,Gansu Province,Lanzhou 730050,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃兰州730000 [2]甘肃省妇幼保健院过敏反应科,甘肃兰州730050

出　　处：《妇儿健康导刊》2025年第2期193-198,共6页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

基　　金：甘肃省兰州市科技计划项目(2022-5-74)。

摘　　要：目的根据呼吸道多种病原体靶向测序(tNGS)结果探讨儿童肺炎支原体肺炎(MPP)呼吸道病原谱组成及临床特征。方法选取2023年4月至2024年7月甘肃省妇幼保健院儿科收治的402例患儿,根据tNGS是否检测出肺炎支原体分为MPP组(n=255)和非MPP组(n=147)。分析患儿呼吸道病原谱组成及临床特征。结果两组年龄分布比较,差异有统计学意义(P<0.05)。MPP组较非MPP组咳嗽时间短、高热比例高、总热程长、住院天数长(P<0.05)。MPP组外周血白细胞计数、淋巴细胞百分比、降钙素原及白蛋白均低于非MPP组,中性粒细胞百分比、C反应蛋白、D-二聚体及红细胞沉降率均高于非MPP组(P<0.05);两组乳酸脱氢酶比较,差异无统计学意义(P>0.05)。MPP组较非MPP组湿啰音、呼吸音减低比例更高,痰鸣音、喘鸣音比例更低,胸部CT表现为大叶性肺炎、肺实变、胸腔积液比例更高(P<0.05);两组肺不张比例比较,差异无统计学意义(P>0.05)。MPP组常见单一大环内酯类耐药肺炎支原体感染,非MPP组最常见细菌、病毒混合感染。结论MPP患儿临床特征不典型,年龄、高热、总热程、肺部体征、相关实验室指标、胸部CT表现等对临床诊治有提示作用。采用tNGS方法检测儿童MPP呼吸道微生物的检出率高,有助于识别混合病原体感染。Objective To explore the composition of the respiratory pathogen spectrum and clinical characteristics of Mycoplasma pneumoniae pneumoniae(MPP)in children based on the results of targeted next generation sequencing(tNGS).Methods A total of 402 children admitted to the Department of Pediatrics,Gansu Provincial Maternal and Child Health Hospital from April 2023 to July 2024 were selected and divided into the MPP group(n=255)and the non-MPP group(n=147)according to whether Mycoplasma pneumoniae was detected in tNGS.The composition of the pathogenic spectrum and clinical features of of children were analyzed.Results There was significant difference in age distribution between the two groups(P<0.05).Compared with non-MPP group,MPP group had shorter cough duration,higher proportion of high fever,longer total heat course,and longer hospital days(P<0.05).The white blood cell count,lymphocyte percentage,procalcitonin and albumin in peripheral blood of the MPP group were lower than those of the non-MPP group,and the neutrophil percentage,C-reactive protein,D-dimer and erythrocyte sedimentation rate were higher than those of the non-MPP group(P<0.05).There was no significant difference in lactate dehydrogenase between the two groups(P>0.05).Compared with the non-MPP group,the MPP group had a higher proportion of moist rale and decreased breath sound,a lower proportion of phlegm rale and stridor,and a higher proportion of chest CT manifestations of lobar pneumonia,pulmonary consolidation and pleural effusion(P<0.05).There was no significant difference in the proportion of atelectasis between the two groups(P>0.05).Single macrolide resistant Mycoplasma pneumoniae was the most common infection in the MPP group,while mixed infection of bacteria and viruses was the most common infection in the non-MPP group.Conclusion The clinical features of children with MPP are atypical,age,high fever,total duration of fever,pulmonary signs,relevant laboratory indicators and chest CT manifestations are suggestive of the clinical diagnosis and

关 键 词：靶向测序 肺炎支原体肺炎 病原学 

分 类 号：R725.6[医药卫生—儿科]