465例儿童肺炎支原体肺炎的流行病学及临床特征分析:一项单中心回顾性研究  

Analysis of epidemiological and clinical characteristics of 465 pediatric cases of Mycoplasma pneumoniae pneumonia:a single⁃center retrospective study

作　　者：吕奎林 陈虹 Lyu Kuilin;Chen Hong(Department of Pediatrics,The Second Affiliated Hospital of Army Medical University,Chongqing 400037,China;Department of Pulmonary and Critical Care Medicine,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院呼吸与危重症医学科,重庆400016 [2]陆军军医大学第二附属医院儿科,重庆400037

出　　处：《中华肺部疾病杂志(电子版)》2025年第1期55-61,共7页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：重庆市卫生健康委员会医学领域名师计划(CQYC20220203178)。

摘　　要：目的分析儿童肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)的流行病学变迁及重症化临床特征,探讨2023年后肺炎支原体(Mycoplasma pneumoniae,MP)感染高发趋势的潜在影响因素,为优化诊疗策略提供参考。方法回顾性纳入我院2018年1月至2024年5月MPP住院患儿临床资料,分析人口统计学、流行病学、临床特征、及轻、重症肺炎的影像学、实验室指标、治疗差异。结果2023年后MP⁃IgM检测阳性率显著升高,2023年10.61%,2024年1~5月18.12%,住院MPP占比达11.16%~13.73%。观察组患儿年龄中位数6岁,发热260例(86.38%)、高热144例(47.84%)、退热药使用254例(84.39%)高于对照组年龄中位数3岁、102例(62.20%)、40例(24.39%)、88例(53.65%)(P<0.05)。影像学显示,观察组多肺叶受累2~3肺叶144例(47.84%)、高密度病灶200例(66.45%)、肺实变86例(28.57%)较对照组16例(9.76%)、41例(25.00%)、10例(6.01%)常见(P<0.005)。观察组CRP(14.62±18.45)mg/L、PCT(0.16±0.38)ng/ml、激素使用214例(71.10%)、四环素类药物应用70例(23.26%)较对照组(9.82±13.38)mg/L、(0.10±0.14)ng/ml,63例(38.41%)、30例(18.30%)高。两组住院天数无差异,观察组胸片复查119例(39.05%)、炎症吸收延迟97例(32.23%)较对照组34例(20.73%)、25例(15.24%)增加(P<0.001)。结论2023年后儿童MP感染呈重症化趋势,重症MPP以年长儿、高热、多肺叶受累及炎症标志物升高为特征。早期肺部影像学联合MP核酸及耐药基因检测对重症MPP鉴别有意义,四环素类药物及激素的合理使用需结合耐药监测及个体化分析。Objective To analyze the epidemiological changes and clinical characteristics of severe Mycoplasma pneumoniae pneumonia(MPP)in children,and to explore potential factors influencing the rising trend of M.pneumoniae(MP)infections post⁃2023,providing insights for optimizing treatment strategies.Methods A retrospective review of clinical data from children hospitalized with MPP between January 2018 and May 2024 was conducted.Demographic,epidemiological,and clinical features were analyzed,along with differences in imaging,laboratory findings,and treatment between mild and severe cases.Results Post⁃2023,the positive rate of MP⁃IgM detection significantly increased,reaching 10.61%in 2023 and 18.12%from January to May 2024.Hospitalized MPP cases accounted for 11.16%to 13.73%.The median age of the observed group was 6 years,with higher incidences of fever(86.38%),high fever(47.84%),and antipyretic use(84.39%)compared to the control group(median age 3 years,62.20%,24.39%,and 53.65%,respectively;P<0.05).Imaging revealed that the observed group had more cases with multi⁃lobe involvement(47.84%),high⁃density lesions(66.45%),and lung consolidation(28.57%)compared to the control group(9.76%,25.00%,and 6.01%,respectively;P<0.005).The observed group also had higher CRP(14.62±18.45 mg/L),PCT(0.16±0.38 ng/ml),steroid use(71.10%),and tetracycline use(23.26%)compared to the control group(9.82±13.38 mg/L,0.10±0.14ng/ml,38.41%,and 18.30%,respectively).Hospital stay duration did not differ,but the observed group had more chest X⁃ray re⁃examinations(39.05%)and delayed inflammation resolution(32.23%)compared to the control group(20.73%and 15.24%,respectively;P<0.001).Conclusion Post⁃2023,MP infections in children have shown a trend towards severity,characterized by older age,high fever,multi⁃lobe involvement,and elevated inflammatory markers.Early lung imaging combined with MP nucleic acid and drug resistance gene testing is valuable for identifying severe MPP.The rational use of tetracyclines and steroids should be

关 键 词：肺炎支原体 肺炎 儿童 临床特征 

分 类 号：R563[医药卫生—呼吸系统]