目的 探讨肺炎支原体（MP）23 S rRNA A 2063 G基因变异的社区获得性肺炎（CAP）的临床表型与胸部影像 的关系。方法 以2019年3月至2020年3月住院的142例CAP患儿为研究对象，用肺炎胸片吸收评价量表对其胸部影像 学检查进行评分。同时完善血常规、CRP、MPIgG、MPIgM、咽拭子MP聚合酶链反应等实验室检查，根据病原体结果分为 MPP组和非MPP（N-MPP）组。对MP-PCR阳性患儿，进一步完善23 S rRNA A2063G位点检测，根据是否存在A2063 G变 异，再分为变异组（G-MPP）组和未变异组（A-MPP）组，比较不同组之间的临床表型。结果 纳入142例患儿，男78例、女 64例，中位年龄5岁（范围1个月~14岁）。MPP组与N-MPP组比较，年龄差异有统计学意义（P

Objective To explore the relationship between the clinical phenotype and chest imaging of communityacquired pneumonia (CAP) with the mutation of Mycoplasma pneumoniae (MP) 23 S rRNA A 2063 G gene. Methods A total of 142 children with CAP hospitalized from March 2019 to March 2020 were selected as the research objects. The chest imaging examinations were scored by the pneumonia chest radiograph absorption evaluation scale. At the same time, the blood routine, CRP, MPIgG, MPIgM, MP polymerase chain reaction of throat swab and other laboratory tests were performed. The children were divided into MPP group and non-MPP group (N-MPP) according to the pathogen results. For MP-PCR positive children, the 23 S rRNA A 2063 G site was further detected. The children were divided into the variant group (G-MPP) and the non-variant group (A-MPP) according to whether there is A2063G mutation, and the differences in clinical phenotypes between the two groups were compared. Results In a total of 142 children included, there were 78 males and 64 females with a median age of 5 years (range from one month to 14 years). The age difference between MPP group and N-MPP group was statistically significant (P< 0 . 05 ). Twenty-seven patients in the MPP group had 23 S rRNA A 2063 G mutation and a variation rate was 30 . 34 %. Compared with A-MPP group, G-MPP group had longer fever duration, longer hospital stay, higher incidence of hypoxemia, and higher chest imaging scores in children with hypoxemia, and the differences were statistically significant (all P< 0 . 05 ). Conclusions The children with G-MPP had long fever duration, a longer hospital stay, a higher incidence of hypoxemia, and a higher chest imaging score in children with hypoxemia. However, chest imaging scores may not be used to indicate whether drug-resistant MP infection happens.