目的了解不同年龄段难治性肺炎支原体肺炎(RMPP)急性期患儿纤维支气管镜下气道改变特点。方法选取2015年1月-2016年1月在郑州大学第三附属医院确诊为RMPP的住院患儿65例,详细记录患儿的临床资料,并进行统计分析。将所有入选患儿按年龄分为婴幼儿组(<3岁)15例、学龄前儿童组(3~6岁)24例、学龄儿童组(6~15岁)26例。比较不同年龄段儿童RMPP的纤维支气管镜下气道改变的差异。结果婴幼儿组、学龄前儿童组、学龄儿童组急性期气道黏膜充血肿胀、纵行皱褶、分泌物增多、叶或段支气管开口炎性狭窄、管腔软化发生率比较差异无统计学意义(P>0.05);婴幼儿组、学龄前儿童组、学龄儿童组气道黏液栓阻塞发生率比较差异有统计学意义(P<0.05),学龄儿童组、学龄前儿童组的发生率较婴幼儿组显著增高;3组管腔闭塞、管腔肉芽组织增生、黏膜糜烂发生率较低,差异无统计学意义(P>0.05)。结论不同年龄段RMPP急性期儿童纤维支气管镜下气道改变不同,尤其婴幼儿与学龄期儿童之间的差异更明显。 Objective To understand the characteristics of airway changes in patients with refractory mycoplasma pneumoniae pneumonia (RMPP) at different ages. Methods Sixty-five inpatients with RMPP diagnosed as RMPP at the Third Affiliated Hospital of Zhengzhou University from January 2015 to January 2016 were selected and their clinical data were recorded in detail and statistically analyzed. According to age, all children were divided into infants and young children group (<3 years old) 15 cases, preschool children group (3-6 years old) 24 cases, school-age children group (6-15 years old) 26 cases. Differences in airway changes under fiberoptic bronchoscopy between children of different ages were compared. Results Infants, preschool children and school-age children had acute airway mucosal hyperemia, longitudinal ruffles, increased secretions, inflammatory stenosis of leaf or segment bronchial openings, and no significant difference in the incidence of lumenal softening (P> 0.05). There was significant difference in the incidence of airway mucus plug between infants, preschool children and school-age children (P <0.05), and the incidence of preschool children was higher than that of infants Infant group was significantly higher; 3 groups of lumen occlusion, luminal granulation tissue proliferation, mucosal erosion was lower, the difference was not statistically significant (P> 0.05). Conclusion The airway changes in children with RMPP in different age groups are different under the bronchofibroscopy, especially the difference between infants and school-age children is more obvious.