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山东大学学报(医学版) ›› 2009, Vol. 47 ›› Issue (9): 125-128.

• 论文 • 上一篇    下一篇

肺炎支原体下呼吸道感染的临床特征分析

魏伟   

  1. 山东大学齐鲁医院儿内科,济南 250012
  • 收稿日期:2009-05-03 发布日期:2009-09-16
  • 作者简介:魏伟(1970- ),女,博士,主治医师,主要从事儿科血液肿瘤学的研究。 Email: weiwei@sdu.edu.cn

Epidemiological and clinical characteristics of mycoplasm pneumonia (MP) 
infection in communityacquired lower respiratory tract
infection among hospitalized children

WEI Wei   

  1. Department of Pediatrics, Qilu Hospital of Shandong University, Jinan 250012, China
  • Received:2009-05-03 Published:2009-09-16

摘要:

目的分析住院儿童社区获得性下呼吸道感染肺炎支原体(MP) 的流行特点,提高对小儿MP肺炎的诊疗水平。 方法回顾性分析2007年1 月至2008 年12 月876 例社区获得性下呼吸道感染(CALRTI )住院儿童的临床资料。采用被动颗粒凝集法检测患者急性期血清MPIgM, 滴度≥1:80为血清学诊断标准。结果876例患儿,急性MP感染177例 (20.2%), 6个月~14岁,平均5.1岁。3岁以上儿童占79.7%,有88/119例MPIgM滴度≥1:320;3岁以下有25/58例,差异显著(χ2=16.1, P<0.005)。持续性咳嗽、发热是支原体下呼吸道感染的主要特征,但婴幼儿多见中度发热、喘憋多、肺部体征明显;胸部X线以支气管肺炎或间质性肺炎改变为主,大叶性肺炎改变很少;肺外并发症少。儿童期多见高热、干咳为主,咳嗽顽固剧烈,肺部体征少,胸片以大叶性改变为主,合并胸腔积液多,肺外并发症多。结论肺炎支原体是CALRTI住院儿童重要的致病原, 多见于3岁以上儿童。MP感染率随年龄增高而升高,春、秋、冬季为感染发病高峰季节。婴幼儿与儿童MP感染的临床表现差异较大。

关键词: 肺炎,支原体, 儿童, 呼吸道感染

Abstract:

To summarize the epidemiological and clinical characteristics of mycoplasm pneumonia (MP) infection in communityacquired lower respiratory tract infection (CALRTI) among hospitalized children. MethodsA retrospective analysis of a database of 876 patients with CALRTI at the Qilu Hospital of Shandong University between 2007 and 2008 was performed. Serologic diagnosis for MP infection was made based on single titers ≥1∶80, which was measured by a passive particle agglutination test. ResultsMP infection was diagnosed in 177 patients aged from 6 months to 14 years. The mean age was 5.1 years. Children older than 3 years accounted for 79.7%. The frequency of titer of MPIgM ≥1:320 was significantly higher in patients older than 3 years than in those younger than 3 (88/119 vs 25/58, 73.9% vs 43.1%). Prolonged cough and fever were leading symptoms. In children younger than 3 years, moderate fever and wheezes on auscultation are the main clinical features. Chest Xray showed typical radiological features such as peribronchial and perivascular interstitial infiltrates, with very few massive infiltrations. Extrarespiratory complications were rare.  In children older than 3 years, high fever and persistent dry cough were prominent features with less manifestation on auscultation. Massive infiltrations  and pleural infusion were often seen on chest Xray and extrarespiratory complications were common. ConclusionsMycoplasma pneumonia infection is frequent in children over 3 years among hospitalized CALRTI patients. The infective rate increases as the age increases. The infective rate in summer is significantly lower than that in spring, autumn and winter. The clinical features are obviously different between patients older and younger than 3 years.

Key words: Pneumonia, mycoplasma; Child;  Respiratory tract infections

中图分类号: 

  • R725.6
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