儿童塑型性支气管炎临床特点及合并特应质的影响  

Clinical Characteristics and Effects of Atopy in Pediatric Plastic Bronchitis

作　　者：陈洪佳 夏万敏 艾涛 樊映红 谢诚 张莹 黄懿洁 Chen Hongjia;Xia Wanmin;Ai Tao;Fan Yinghong;Xie Cheng;Zhang Ying;Huang Yijie(Chengdu Women's and Children's Central Hospital·The Affiliated Women's and Children's Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu 611731,China)

机构地区：[1]电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院儿童呼吸内科,成都611731

出　　处：《成都医学院学报》2025年第2期261-264,270,共5页Journal of Chengdu Medical College

基　　金：四川省科技厅省级科技计划项目(No:23NSFSC5420)。

摘　　要：目的 分析儿童塑型性支气管炎(PB)的临床特点,探讨合并特应质对PB患儿的影响。方法 选取2023年1月至2024年6月于成都市妇女儿童中心医院经支气管镜检查诊断为PB的患儿100例作为研究对象,以是否合并特应质分为特应质组和非特应质组。分析两组患儿在一般资料、临床特点、实验室检查、影像学特征、病原结果和治疗等方面差异是否有统计学意义。结果 PB患儿中男59例,女41例,男∶女构成比为1.44∶1;年龄为1岁3月~16岁,中位年龄7岁,>5岁患儿88例;25例患儿合并特应质;97例患儿有发热,热程1~15(7.10±2.49)d,热峰为(39.91±0.77)℃;100例患儿有咳嗽,18例患儿存在气促。100例患儿均行胸部X线片和/或胸部CT检查,影像学检查发现:87例患儿有肺实变,34例有肺不张,41例有胸腔积液,43例有气道黏液栓征象。100例患儿均找到相关病原体,其中95例为肺炎支原体感染,包含65例单纯肺炎支原体感染及30例混合感染;4例博卡病毒感染,其中1例为单纯感染,3例为混合感染;腺病毒3例,其中1例为单纯感染,2例为混合感染;其余少见病原体均为混合感染。单因素分析发现,特应质组患儿发病年龄低于非特应质组,肺部听诊呼吸音减弱、胸部CT肺不张及气道黏液栓比例均高于非特应质组(P<0.05)。结论 持续高热,伴气促,听诊呼吸音减弱,胸部CT提示肺实变、肺不张、气道黏液栓或合并胸腔积液的肺炎,尤其合并特应质患儿,需高度警惕PB可能,建议尽早行支气管镜检查,必要时经支气管镜取出黏液栓改善气道通气。Objective To summarize the clinical features of pediatric plastic bronchitis(PB),and to explore the effects of combined atopy on PB.Methods The clinical data of a total of 100 children diagnosed with PB by bronchoscopy in Chengdu Women's and Children's Central Hospital from January 2023 to June 2024 were retrospectively collected.The included children were assigned to the atopic group or the non-atopic group according to whether they were combined with atopy.The general data,clinical features,results of laboratory tests,imaging features,pathogen tests results and treatment of the two groups were analyzed to see if there were statistical differences.Results Among the 100 PB children included,59 were male and 41 were female,with a male to female ratio of 1.44:1.The children ranged in age from 1 year 3 months to 16 years old,with a median age of 7 years old,and 88 of the children over 5 years old.There were 25 children with atopy.There were 97 cases with fever,ranging from 1 to 15 d,with an average febrile duration of(7.10±2.49)d and a heat peak of(39.91±0.77)℃.All the 100 children had cough and 18 cases had shortness of breath.Chest X-ray and/or chest computed tomography(CT)examination were performed in all 100 patients.It was found that 87 cases had lung consolidation,34 cases had atelectasis,41 cases had pleural effusion,and 43 cases had signs of airway mucus plug.Related etiology was found in all 100 cases,of which 95 cases were mycoplasma pneumoniae infection,including 65 cases of simple mycoplasma pneumoniae infection and 30 cases of mixed infection.There were 4 cases of Boca virus infection,of which 1 was simple infection and 3 were mixed infection.There were 3 cases of adenovirus,of which 1 case was simple infection and 2 cases were mixed infection.Other rare pathogens were all mixed infections.Univariate analysis showed that compared with the non-atopic group,the atopic group showed a younger age of onset,weaker respiratory sounds upon lung auscultation,and higher proportion of cases with chest CT atele

关 键 词：塑型性支气管炎 成都地区 儿童 肺炎支原体 特应质 

分 类 号：R725[医药卫生—儿科]