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目的探讨肺炎支原体(MP)感染诱发的儿童哮喘临床发病特征。方法选择2006年1-12月中国医科大学附属盛京医院小儿呼吸内科收治的确诊为MP感染诱发的哮喘发作患儿50例为MP感染诱发组,并以同期入院的非MP感染诱发的哮喘患儿40例为对照组,对两组患儿的临床特点、喘息特征、辅助检查特点及对哮喘药物治疗的反应等进行分析。结果MP感染诱发组的哮喘发作年龄以3岁以上多发(60%),平均发病(4.4±2.9)岁;MP感染诱发组患儿喘息反复史、发热、热程、对支气管扩张剂的反应、咳喘持续时间、住院时间,以及C反应蛋白(CRP)、嗜酸细胞计数、肝功受累、心肌受累的发生率与对照组差异均有统计学性意义(P<0.05);在呼吸系统受累方面,MP感染诱发组以肺炎为主,而对照组则以上呼吸道感染多见(P<0.05);MP感染诱发组与对照组在患病高峰、个人及家族特应性病史、WBC、PCT、免疫球蛋白、总IgE的实验室指标上差异无统计学意义(P>0.05);MP感染诱发组应用平喘药联合大环内酯类抗生素治疗收到良好疗效。结论MP感染诱发的儿童哮喘发作具有自己的特征,平喘药联合大环内酯类抗生素治疗有效。
Objective To investigate the clinical features of childhood asthma induced by Mycoplasma pneumoniae (MP) infection. Methods Fifty children diagnosed as MP-infected asthma admitted to Shengjing Hospital Affiliated to China Medical University from January to December 2006 were selected as MP infection-induced group and asthma patients with non-MP infection admitted in the same period 40 cases of children as control group, the clinical features of two groups of children, wheezing characteristics, the characteristics of laboratory examinations and response to asthma drug therapy were analyzed. Results The age of onset of asthma in MP infection-induced group was more than 3 years old (60%) with an average incidence of (4.4 ± 2.9) years. In children with MP-induced infection, repeated episodes of wheeze, fever and fever, bronchodilator response, Cough duration, length of hospital stay, and CRP, eosinophil count, liver function involvement, and incidence of myocardial involvement were significantly different from those in the control group (P <0.05) In the MP infection-induced group, pneumonia was the predominant group, while the control group was more common in the upper respiratory tract infection group (P <0.05). In the MP-induced group and the control group, there were significant differences in the prevalence, personal and family history of atopy, WBC, PCT, Immunoglobulin, total IgE in laboratory indicators was no significant difference (P> 0.05); MP infection induced group of antiasthmatic drugs combined with macrolide antibiotics received good results. Conclusion MP infection-induced childhood asthma attacks have their own characteristics, antiasthmatic drugs combined with macrolide antibiotics effective.