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[摘要]目的 探讨儿童肺炎支原体（MP）感染相关性心包炎的发病机制、临床表现、诊治要点以及预后。方法 回顾性性分析2009年2月～2017年3月我院收治的15例肺炎支原体感染相关性心包炎患儿的临床表现、辅助检查、治疗经过和转归。结果 15例患儿中女童（9例）多于男童（6例），占我院同期因支原體感染住院患儿的1.9%（15/785）。平均发病年龄为7.66岁（11个月～12岁）；临床表现多样，93.3%（14/15例）的患儿存在呼吸道感染表现，33.3%（5/15）例患儿同时合并神经系统症状。血清MP抗体阳性检出率为100%，血清MP DNA检出率为86.7%（13/15例），而心包穿刺液MP DNA检出率为0（0/7例）。心电图异常达93.3%（14/15例）；心包积液以少-中量为主（12/15例），少量积液6例，中量积液6例，大量积液3例；所有患儿均以抗支原体治疗，7例患儿经心包穿刺引流，临床症状改善，心包积液吸收，随防无缩窄性心包炎发生。结论 MP感染相关性心包炎是MP感染的少见肺外表现，部分患儿伴有神经系统症状，超声心动图和血清MP抗体对此病的诊断价值较大，经过合理治疗预后良好。

[关键词]肺炎支原体；心包积液；超声心动图；儿童

[中图分类号] R725.631 [文献标识码] A [文章编号] 1674-4721（2017）09（b）-0083-04

Clinical analysis of pericarditis associated with Mycoplasma Pneumoniae infection in children

LIU Lin HU Yu-hui LIU Cong TAN Wei-qun

Department of Cardiology，Shenzhen Children′s Hospital，Guangdong Province，Shenzhen 518026，China

[Abstract]Objective To explore the mechanism，clinical manifestations，treatment and prognosis of pericarditis associated with Mycoplasma Pneumoniae （MP） infection in children.Methods Data of 15 cases suffered from pericarditis associated with MP infection from February 2009 to March 2017，including clinical manifestations，laboratory examinations，treatment and prognosis were collected and analyzed retrospectively.Results There were more girls （9 cases） than boys （6 cases） in this study，accounted for 1.9% （15/785） of hospitalized children with mycoplasma pneumoniae infection.The mean age was 7.66 years （11 months to 12 years old）.There was diversity in clinical manifestations，93.3% （14/15 cases） of the patients had symptoms of respiratory tract infection，33.3% （5/15 cases） had neurological symptoms.The serum MP antibody was positive in all patients，the serum MP DNA was detected in 86.7% patients.However，MP DNA was negative in pericardial fluid in all patients.Abnormal ECG was found in 14 cases （93.3%）；Echocardiogram revealed mild pericardial effusions in 6 cases，moderate pericardial effusions in 6 cases，massive pericardial effusions in 3 cases.All patients were treated with anti-MP therapy，7 cases received additional pericardial puncture and drainage，all patients′ symptoms improved greatly，and pericardial effusions decreased significantly.No one had constrictive pericarditis in the follow up.Conclusion Pericarditis is a rare extrapulmonary manifestation of MP infection in children.Some patients have neurological symptoms.Echocardiography and serum MP antibodies are of great value in the diagnosis of this disease.Generally speaking，the prognosis is good after apropriate treatment.endprint

[Key words]Mycoplasma Pneumoniae；Pericarditis；Echocardiography；Child

肺炎支原体（Mycoplasma Pneumoniae，MP）是学龄期以及学龄前期儿童社区获得性肺炎的主要病原体之一。除呼吸系统外，MP感染可累积其他系统，如神经系统、心血管系统、血液系统等[1]，导致肺外表现。MP感染相关性心包炎是MP感染少见的肺外表现，发病率占MP感染患者的1%～5%[2]。由于该病发病率不高，表现多样，部分儿科医师对其认识不足，可能导致误诊。本研究就15例MP感染相关性心包炎病例资料进行总结分析，并复习相关文献，旨在探讨其发病机制、临床特点和诊治要点。……