冉庆国，雷琅嬛，丁　洁，张阳阳，王兴勇

(1.重庆市南川区人民医院妇儿分院儿科，重庆 408400；2.重庆医科大学附属儿童医院急诊科，重庆 400014)



小儿肺炎支原体肺炎120例临床分析

冉庆国1，雷琅嬛2，丁洁2，张阳阳2，王兴勇2

(1.重庆市南川区人民医院妇儿分院儿科，重庆 408400；2.重庆医科大学附属儿童医院急诊科，重庆 400014)

目的探讨小儿肺炎支原体肺炎(MPP)的临床特点、治疗方法及疗效，以提高临床诊治水平。方法回顾性分析重庆市南川区人民医院2009至2012年收治的120例MPP患儿的临床资料。结果在120例患儿中，男66例，女54例；5岁以下患儿占36.7%(44例)；常见的临床症状为：咳嗽占85.0%(102例)、发热占83.3%(100例)，年龄较小的患儿更容易出现喘息；体征：双肺呼吸音增粗或减低占40.0%(48例)，湿性啰音占22.5%(27例)，喘息占8.3%(10例)；肺外系统受累占64.2%(77例)，心血管系统受累占36.7%(44例)，消化系统受累占26.7%(32例)；胸片以小斑片或扇形浸润、节段性实变浸润最常见；血清肺炎支原体IgM检测占98.3%(118例)。患儿经阿奇霉素序贯治疗均预后良好。结论儿童MPP临床表现复杂，且易累及肺外系统，但及时准确诊断及合理治疗多数预后良好。

肺炎支原体；肺炎；儿童；临床特点；治疗

[Abstract]Objective To explore the clinical features, therapeutic methods and efficacy of mycoplasma pneumoniae pneumonia (MPP) in children and to improve the diagnosis and treatment level. Methods Retrospectively analysis was conducted on clinical data of 120 children with MPP admitted to People’s Hospital of Nanchuan during 2009-2012. Results There were 66 male cases and 54 female cases. Cases under 5 years occupied 36.7% (44 cases). Most common clinical manifestations were cough (102 cases, 85.0%) and fever (100 cases, 83.3%). Wheezing occurred more easily in younger children. Pulmonary sign revealed decreasing or enlargement of breath sounds in 48 cases (40.0%), moist rale in 27 cases (22.5%), and wheezing in 10 cases (8.3%). Involvement of other system was found in 77 cases (64.2%), cardiovascular system was involved in 44 cases (36.7%), and digestive system was involved in 32 cases (26.7%). Most common X-ray manifestations were small patch or fan infiltration, and consolidation of segmental infiltration. Positive rate of mycoplasma pneumonia IgM was proved in 118 cases (98.3%). All children had favorable prognosis after sequential therapy of azithromycin. Conclusion Clinical manifestations of children with MPP are complex and involvement of other systems is very common, but the prognosis is favorable after prompt diagnosis and reasonable treatment.

[Key words]mycoplasma pneumonia (MP); pneumonia; children; clinical characteristics; treatment

肺炎支原体(mycoplasma pneumonia，MP)是引起小儿呼吸道感染的最常见病原体之一，约占小儿下呼吸道感染的10%～40%[1]。肺炎支原体肺炎(mycoplasma pneumoniae pneumonia，MPP)主要发生于学龄期儿童及青少年，其不仅可以出现肺部严重病变，尚可通过免疫机制导致肺外多系统的损害。近年，随着抗生素的广泛应用，耐大环内酯类药物肺炎支原体的感染率呈逐年上升趋势，近期研究显示其耐药率可高达98%，其临床特点较前也有所改变[2]。……