论文部分内容阅读
目的提高对小儿肺炎支原体(MP)肺炎的临床认识和诊治水平。方法对2005-09—2006-05间106例确诊为MP肺炎住院患儿的临床特点进行总结和分析。结果发病年龄多为学龄儿童,613岁占49.1%。持续发热伴刺激性咳嗽的患儿占93.4%,早期无明显阳性体征。MP痰培养阳性率低,仅为6.6%。但用颗粒凝集法检测血清MP-IgM阳性率高(92.5%)。外周血白细胞大多正常(占71%),但血沉(85.0%)及CRP(52.0%)都升高。胸片以一侧大片絮状阴影为多见,占88.7%,右侧(57.6%)多于左侧,下叶(72.3%)多于中上叶。35例(33.0%)有肺外合并症,伴有渗出性胸膜炎者占39.4%,此外尚有贫血、肝损害等。所有病例用红霉素、阿奇霉素治疗效果良好,尚未发现耐药情况。结论小儿MP肺炎好发于学龄儿童,颗粒凝集法检测血清Mp-IgM阳性率高,利于早期诊断。
Objective To improve the clinical knowledge and diagnosis and treatment of children with Mycoplasma pneumoniae (MP) pneumonia. Methods The clinical features of 106 hospitalized children with MP pneumonia diagnosed between September 2005 and June 2006 were summarized and analyzed. Results The age of onset was mostly school-age children, accounting for 49.1% at 613 years. Sustained fever with irritating cough in children accounted for 93.4%, early no significant positive signs. The positive rate of MP sputum culture was low, only 6.6%. However, the positive rate of MP-IgM detected by particle agglutination was high (92.5%). Most peripheral blood leukocytes were normal (71%), but ESR (85.0%) and CRP (52.0%) were elevated. Chest radiographs were more common on the side of large flocculent shadows, accounting for 88.7%, right side (57.6%) more than left side, lower lobe (72.3%) more than middle lobe. 35 cases (33.0%) had extrapulmonary complication, with exudative pleurisy accounted for 39.4%, in addition to anemia, liver damage and so on. All cases with erythromycin, azithromycin treatment is good, no drug resistance has been found. Conclusion MP pneumonia in children occurs in school-age children. The positive rate of serum Mp-IgM detected by particle agglutination is high, which is good for early diagnosis.