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目的探讨儿童肺炎支原体肺炎(MPP)的临床特点及治疗方法。方法对240例确诊为MPP患儿的临床资料进行回顾性分析。240例MPP患儿随机分为两组,治疗组给予阿奇霉素10 mg/kg.d静滴治疗5 d后停7 d,改用阿奇霉素口服,服3 d停4 d总疗程3周;对照组给予红霉素40 mg/kg.d静滴7 d后改口服红霉素,总疗程3周。结果本组患儿以学龄儿童为主。发热203例(84.58%),持续性咳嗽192例(80.00%)。多数肺部可闻及湿罗音。肺外并发症主要为消化系统、心血管系统、中枢神经系统和泌尿系统损害。血清肺炎支原体特异性IgM抗体(MP-IgM)均阳性。治疗7 d后疗效比较:治疗组有效率96.7%,对照组有效率61.7%。结论儿童MPP好发于学龄儿童,肺外并发症可累及多个系统,血清学MP-IgM检测是早期诊断的必要手段,应用阿奇霉素治疗明显优于红霉素,疗效显著,且消化道反应轻。
Objective To investigate the clinical features and treatment of children with Mycoplasma pneumoniae pneumonia (MPP). Methods The clinical data of 240 children diagnosed as MPP were analyzed retrospectively. 240 cases of MPP were randomly divided into two groups, the treatment group given azithromycin 10 mg / kg.d intravenously for 5 days and then stopped for 7 days, changed to azithromycin for 3 days and stopped for 4 days for 3 weeks. The control group was given Erythromycin 40 mg / kg.d intravenous infusion of oral erythromycin after 7 d, the total course of 3 weeks. Results This group of children to school-based children. Fever 203 cases (84.58%), persistent cough in 192 cases (80.00%). Most lungs can smell wet rales. Extra-pulmonary complications mainly digestive system, cardiovascular system, central nervous system and urinary system damage. Serum Mycoplasma pneumoniae-specific IgM antibodies (MP-IgM) were positive. After 7 days of treatment, the curative effect was compared: the effective rate of the treatment group was 96.7% and that of the control group was 61.7%. Conclusion MPP in children is more common in school-age children. Pulmonary complications may involve multiple systems. Serum MP-IgM detection is an essential measure for early diagnosis. Azithromycin treatment is superior to erythromycin, with significant curative effect and mild gastrointestinal reaction .