儿童肺炎支原体肺炎的流行特征及临床分析

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目的:了解肺炎支原体肺炎(MPP)患儿的流行特征及临床特点。方法:对2013年12月至2014年11月在我院住院诊断为社区获得性肺炎(CAP)的371例患儿,行乳胶被动凝集法测定血清肺炎支原体(MP)特异性抗体Ig M,其中179例诊断为MPP。分析MPP好发季节及年龄段,并研究不同年龄段MPP的临床特征及治疗。结果:(1)我院CAP患儿在学龄期儿童中MP感染率最高(81.08%),婴儿期患儿感染率最低(12.73%),4组MP感染率差异具有统计学意义(P<0.001)。(2)我院CAP患儿在夏季及秋季MP-Ig M检出阳性率分别为60%、54.72%,明显高于冬春季(均P<0.05)。(3)179例MPP患儿中,婴儿组患儿表现为喘息症状发生率为71.43%,明显高于学龄前期及学龄期患儿(均P<0.05)。学龄期患儿表现为喘息症状发生率为15%,明显低于其他年龄组患儿(P<0.05)。学龄期患儿激素使用率为30%,明显高于幼儿期及学龄前期患儿(均P<0.05)。(4)婴幼儿组患儿血常规中白细胞计数较学龄前期及学龄期患儿高(均P<0.05),学龄前期及学龄期患儿血常规中性粒细胞百分比较婴幼儿组高(均P<0.05),但仍处于正常范围值内,各年龄组C反应蛋白差异无统计学意义(P>0.05)。结论:肺炎支原体肺炎在夏秋季多见,学龄期儿童发生率较高,且学龄期患儿激素使用率相对较高,可能与不同年龄段患儿的免疫状态有关。 Objective: To understand the prevalence and clinical features of children with Mycoplasma pneumoniae pneumonia (MPP). Methods: A total of 371 children with community-acquired pneumonia (CAP) admitted to our hospital from December 2013 to November 2014 were enrolled in this study. Latex passive agglutination was used to detect serum IgM-specific IgM 179 cases were diagnosed as MPP. MPP incidence season and age analysis, and study of different ages of MPP clinical features and treatment. Results: (1) The prevalence of MP was the highest in CAP children (81.08%) in school-age children and the lowest in infants (12.73%). The MP infection rates in 4 groups were statistically significant (P <0.001 ). (2) The positive rate of MP-Ig M detected by CAP in our hospital in summer and autumn was 60% and 54.72% respectively, which was significantly higher than that in winter and spring (all P <0.05). (3) Among the 179 MPP infants, the rate of wheezing in infants was 71.43%, which was significantly higher than that in preschool children and school-age children (all P <0.05). The incidence of wheezing in school-age children was 15%, significantly lower than that in other age groups (P <0.05). The use rate of hormone in school-age children was 30%, significantly higher than those in early childhood and pre-school age children (all P <0.05). (4) Infants and toddlers had higher blood routine white blood cell counts than those in preschool children and school-age children (all P <0.05). The percentage of presumptive neutrophils in preschool children and school-age children was higher than those in infants P <0.05), but still within the normal range. There was no significant difference in C-reactive protein in all age groups (P> 0.05). Conclusions: Mycoplasma pneumoniae pneumonia is more common in summer and autumn, the incidence of school-age children is higher, and the use rate of hormone in school-age children is relatively high, which may be related to the immune status of children in different age groups.
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