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目的探讨肺炎支原体(MP)肺炎呈大叶性肺炎改变的临床特征和诊治要点。方法对2008年12月至2009年12月收治的19例临床具有呼吸道症状和体征,X线胸片提示为大叶性肺炎改变,被动凝集法MP-IgM阳性的MP肺炎患儿的临床资料进行回顾性分析。结果 MP肺炎呈大叶性肺炎改变者临床有以下特点:(1)学龄前儿童(10例)与学龄儿童(9例)感染率相当,且可集体发生。(2)起病较急,呼吸道症状突出,持续高热多见(14例),早期肺部体征多不明显,部分病例双肺均可闻及湿罗音。(3)心肌损害多见(7例)。(4)白细胞总数多不升高,C-反应蛋白大多升高(13例),经有效治疗2～3周,X线胸片示病灶多可完全吸收。结论需掌握MP肺炎的临床特征,注意MP肺炎X线胸片改变的多样性。大叶性MP肺炎常混合细菌感染,混合细菌感染者,早期予以大环内酯类与三代头孢菌素联合治疗,疗效确切。
Objective To investigate the clinical features and diagnosis and treatment of lobar pneumonia in Mycoplasma pneumoniae (MP) pneumonia. Methods From December 2008 to December 2009, 19 patients with respiratory symptoms and signs of clinical manifestations, X-ray showed changes in the lobar pneumonia, passive agglutination MP-IgM positive MP pneumonia in children with clinical data Retrospective analysis. The results of MP pneumonia lobular pneumonia were clinically the following characteristics: (1) preschool children (10 cases) and school-age children (9 cases) infection rate comparable, and can occur in groups. (2) more acute onset, prominent respiratory symptoms, persistent high fever more common (14 cases), early lung signs were more obvious, in some cases both lungs can smell wet rales. (3) Myocardial damage more common (7 cases). (4) The total number of white blood cells is not increased, C-reactive protein is mostly elevated (13 cases), effective treatment of 2 to 3 weeks, X-ray showed lesions can be completely absorbed. Conclusion The clinical features of MP pneumonia need to be mastered, and attention should be paid to the diversity of MP pneumonia X-ray changes. Loberular MP pneumonia often mixed with bacterial infection, mixed bacterial infection, early macrolides and third-generation cephalosporins combined treatment, the exact effect.