吴勇 蔡俊伟 李立浩

[摘要] 目的 觀察重症肺炎支原体肺炎（MPP）患儿的肺功能动态变化，了解重症MPP患儿肺功能损害的转归。 方法 检测分析2012年6月～2013年9月我院儿科住院的21例重症MPP、21例轻症MPP患儿的急性期及出院后3个月、6个月、1年、1年6个月、2年的常规肺功能和21例同期门诊健康体检小儿（对照组）的常规肺功能，并加以比较。 结果 重症MPP患儿急性期代表大气道通气功能的指标（FVC、PEF、FEV1）与轻症MPP患儿、对照组比较明显降低，差异有统计学意义（P<0.05），重症MPP患儿出院后3个月的FVC、PEF、FEV1与对照组比较，差异无统计学意义（P>0.05）；重症MPP患儿与轻症MPP患儿急性期代表小气道通气功能的指标（FEF25、FEF50、FEF75、FEF25～75）与对照组比较均明显降低（P<0.05），出院后两组患儿代表小气道通气功能的指标均出现逆转；轻症MPP患儿出院后6个月的FEF25、FEF50、FEF75、FEF25～75与对照组比较，差异无统计学意义（P>0.05）；重症MPP患儿出院后1年6个月的FEF25、FEF50、FEF75、FEF25～75与对照组比较，差异无统计学意义（P>0.05）。 结论 重症MPP患儿急性期大气道受损，出院后3个月大气道损伤逐渐恢复正常。重症MPP与轻症MPP急性期均能引起患儿小气道功能的损害，但出院后小气道功能的损害均出现逆转；重症MPP患儿小气道功能恢复较轻症MPP患儿缓慢，但大部分可以恢复正常。

[关键词] 肺炎支原体；肺炎；肺功能；重症

[中图分类号] R725.6 [文献标识码] A [文章编号] 1674-4721（2016）03（a）-0114-03

[Abstract] Objective To observe the dynamic change of pulmonary function in children with Mycoplasma pneumoniae pneumonia （MPP） to comprehend the outcome of pulmonary function injury in children with severe MPP. Methods Routine pulmonary function of 21 children with severe MPP and 21 children with mild MPP admitted into department of pediatrics in our hospital in acute stage，after 3 months，6 months，1 year，6 years and 1 months and 2 years discharge

from June 2012 to September 2013 and another 21 children given healthy physical examination at the same time was tested and analyzed. Results Indicators of major airway ventilatory function including FVC，PEF，and FEV1 at the acute stage in children with severe MPP was significantly decreased compared with mild MPP and control group （P<0.05）.After 3 months discharge，there was no significant difference in FVC，PEF，and FEV1 between severe MPP and control group （P>0.05）.Indicators of minor airway ventilatory function including FEF25，FEF50，FEF75 and FEF25-75 was significantly decreased in acute stage in children with severe MPP and mild MPP compared with control group （P<0.05），and indicators of minor airway ventilatory function was recovered respectively in patients with severe and mild MPP after discharge.After 6 months discharge，there was no significant difference in FEF25，FEF50，FEF75 and FEF25-75 between patients with mild MPP and control group （P>0.05），and no significant difference was observed after 18 months discharge in these indicators between patients with severe MPP and control group （P>0.05）. Conclusion Major airway injury can be observed in acute stage in children with severe MPP，which can gradually recover after 3 months discharge.Minor airway injury can be observed in acute stage in children with severe and mild MPP，which is reversible after discharge.The recovery of minor airway injury is slower in children with severe MPP than in children with mild MPP ，but most of it can be returned to normal.

[Key words] Mycoplasma pneumoniae；Pneumonia；Pulmonary function；Severe case

肺炎支原體（Mycoplasma pneumoniae，MP）已成为儿童社区获得性肺炎的常见病原体之一，而且近几年重症肺炎支原体肺炎（Mycoplasma pneumoniae pneumonia，MPP）病例也有逐年增加的倾向[1-2]。目前尚缺乏详细的对儿童重症MPP的临床肺功能分析和远期随访，其发病机制、有效治疗及预后仍处于未知的阶段。本研究探讨重症MPP患儿约2年肺功能的动态变化情况，为研究其转归及远期效应提供客观依据。

1 资料与方法

1.1 一般资料

资料为2012年6月～2013年9月我院儿科住院的重症MPP患儿21例，轻症MPP患儿21例。重症……