临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (2): 81-.doi: 10.3969/j.issn.1000-3606.2017.02.001

• 呼吸系统疾病专栏 •    下一篇

混合感染因素对难治性肺炎支原体肺炎的影响

陆燕红1, 张新星1, 严永东1, 顾文婧1, 陈正荣1, 朱灿红1, 王宇清1, 黄莉1, 邵雪君2, 季伟1   

  1. 苏州大学附属儿童医院 1 . 呼吸科,2 . 检验科(江苏苏州 215003)
  • 收稿日期:2017-02-15 出版日期:2017-02-15 发布日期:2017-02-15
  • 通讯作者: 季伟 E-mail:szdxjiwei@163.com
  • 基金资助:
    苏州市“科教兴卫”青年科技项目(No.KJXW2016019);国家自然科学基金项目(No. 81570016);国家青年自然科学基金项目( No. 81401296)

Role and influence of coinfection factor to refractory Mycoplasma pneumoniae pneumonia in children

LU Yanhong,ZHANG Xinxing,YAN Yongdong,GU Wenjing,CHEN Zhengrong,ZHU Canhong,WANG Yuqing, HUANG Li, SHAO Xuejun,JI Wei   

  1. 1. Department of Respiratory Disease, 2. Department of Clinical Laboratory, Children's Hospital of Soochow University, Suzhou 215003, Jiangsu, China
  • Received:2017-02-15 Online:2017-02-15 Published:2017-02-15

摘要:  目的 了解混合感染因素对难治性肺炎支原体肺炎(RMPP)的作用及影响。方法 收集并分析2013年1月 至2015年12月286例RMPP患儿的病史资料。依据病原检测结果将患儿分为RMPP混合感染组和单纯感染组,比较两组 患儿临床特征及实验室检查结果。结果 混合感染组患儿热程和住院天数分别为12.5 (11.0~14.0) d、12.00 (9.0~14.0) d, 均明显高于单纯感染组的11.0 (9.0~13.0) d、10.0 (8.0~12.0) d,差异均有统计学意义(P均<0.01)。 混合感染组患儿白 细胞计数,中性粒细胞百分比,血小板计数,乳酸脱氢酶、 C反应蛋白(CRP)> 40 mg/L、CRP>100 mg/L及CK-MB升高 发生率均高于单纯感染组,差异有统计学意义(P均<0.05)。 混合感染组气胸、呼吸衰竭发生率高于单纯感染组,差异均 有统计学意义(P均<0.05)。 混合感染组血液系统损害、心肌损害、电解质紊乱发生率高于单纯感染组,差异均有统计学 意义(P均<0.05)。 结论 混合感染会使RMPP患儿发热时间延长,全身炎症反应加重,肺内外并发症发生率升高,并增 加患儿的住院时间。

Abstract:  Objective To study the role and influence of coinfection factor to refractory Mycoplasma pneumoniae (MP) pneumonia (RMPP) in children. Methods Clinical data and sputum specimen of 286 hospitalized children of RMPP were collected from January, 2013 to December, 2015. According to the results of pathogen detection, children were divided into RMPP coinfection group and simple MP infection group. Clinical features and laboratory tests were compared between the two groups. Results The durations of fever and hospitalization of the RMPP coinfection group were 12.5(11.0-14.0)days and 12.0 (9.0-14.0)days, respectively, which were significantly longer than those of simple MP infection group, 11.0(9.0-13.0)days and 10.0(8.0-12.0)days (Z=3.947, P<0.001, Z=3.519, P<0.001). In the RMPP coinfection group, white blood cell count, the percentage of neutral granulocytes, pleteltes count, lactate dehydrogenase and the incidence of C-reaction protein (CRP) greater than 40 mg/L, and CRP greater than 100 mg/L, elevated CK-MB of were higher than those of simple MP infection group (all P<0.05), but the incidence of CRP greater than 8 mg/L and elevated ALT in the two groups showed no significant difference (both P>0.05). The incidence of pneumothorax and respiratory failure in children of RMPP coinfection group were higher than those in the simple MP infection group (χ2=5.873, P=0.015, χ2=11.995, P=0.001), but the incidence of lobar pneumonia, pleural effusion, atelectasis in the two groups had no significant difference (all P>0.05). The incidence of blood system damage, myocardial damage, skin and joint damage and electrolyte disorders in RMPP coinfection group were higher than those of simple MP infection group (all P<0.05). Conclusions Children with RMPP coinfection tend to be with prolonged duration of fever, increased systemic inflammation, higher incidence of pulmonary and extrapulmonary complications, and longer duration of hospitalization.