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目的探讨儿童肺炎支原体(MP)脑炎的临床特点、诊断与治疗。方法回顾性分析我院2001～2005年确诊的14例MP脑炎患儿的临床资料。结果MP脑炎大部分并发于呼吸道症状后,2例以神经系统症状首发,脑脊液细胞数一般<500×106/L,蛋白轻到中度升高,糖和氯化物基本正常,脑脊液MP-IgM阳性率14.28%(2/14)。采用抗感染等综合措施,全部病例加用激素,4例重症者辅以丙种球蛋白,14例患者均治愈,近期未见后遗症的发生。结论MP脑炎可直接以中枢神经系统症状起病,与病毒性脑炎难以区别,脑脊液MP-IgM阳性率低。诊断要综合考虑,在综合治疗的基础上加用激素及丙种球蛋白可减少后遗症的发生。
Objective To investigate the clinical features, diagnosis and treatment of Mycoplasma pneumoniae (MP) encephalitis in children. Methods The clinical data of 14 children with MP encephalitis diagnosed in our hospital from 2001 to 2005 were retrospectively analyzed. Results Most of MP encephalitis was complicated by respiratory symptoms. The onset of neurological symptoms was found in 2 cases. The number of cerebrospinal fluid cells was generally <500 × 106 / L, the protein was mild to moderately elevated, and the carbohydrate and chloride were almost normal. Cerebrospinal fluid MP-IgM The positive rate was 14.28% (2/14). Adopt anti-infection and other comprehensive measures, all cases plus hormones, 4 cases of severe were supplemented with gamma globulin, 14 patients were cured, no recent occurrence of sequelae. Conclusions MP encephalitis can directly cause central nervous system symptoms, difficult to distinguish with viral encephalitis, and low positive rate of cerebrospinal fluid MP-IgM. Comprehensive diagnosis should be considered in the comprehensive treatment based on the addition of hormones and gamma globulin can reduce the incidence of sequelae.