39例儿童重症肺炎支原体肺炎临床特征及糖皮质激素疗效分析

目的分析儿童重症肺炎支原体肺炎临床特征及观察糖皮质激素的疗效。方法对2013年7月至12月在沈阳市儿童医院诊治的39例重症肺炎支原体肺炎患儿资料进行临床特征,分为激素组及对照组。比较两组热退时间,痉咳时间及住院时间。结果 39例患儿均有发热,咳嗽症状,病程5~10d。白细胞计数29例增高。影像检查均发现大片状密度增高影或肺实质浸润性病变,其中双肺片状影5例,单侧34例。MP-IgM抗体≥160。8例出现胸腔积液,2例出现肺不张,6例出现肝功异常,5例出现心肌酶谱异常,2例出现皮疹。激素组发热时间和痉咳时间分别是(6.7±1.3)d和(5.35±1.62)d,明显短于对照组(8.3±1.4)d和(7.27±1.58)d,两组比较差异均有统计学意义(P0.05);激素组住院时间为(14.8±6.2)d,对照组为(12.8±3.3)d,两组比较差异无统计学意义(P0.05)。结论儿童重症肺炎支原体肺炎可引肺内严重感染及肺外多种并发症,早期应用糖皮质激素治疗,可取得良好效果。

Clinical features of severe mycoplasma pneumoniae pneumonia in 39 children and analysis of curative effect of glucocorticoids

Objective To analyze the clinical features of severe mycoplasma pneumoniae pneumonia (MPP)and observe the curative effect of glucocorticoids.Methods A total of 39 children hospitalized for severe mycoplasma pneumoniae pneumonia from July 2013 to December 2013 were divided into glucocorticoid group and control group.Compare the time of fever relief and spasmatic cough and hospital stay between the two groups.Results All the 39 cases of children had the symptom of fever and spasmatic cough,which las-ted for 5 to 10 days.There were 29 cases whose white blood cell increased.Large piece of shadow or pulmo-nary infiltrates shadows were found in imaging examination,including 5 cases in both sides of lung and 34 ca-ses in one side.All serum MP-IgM was equal to or more than 1 60.Eight cases had pleural effusion,2 cases had pulmonary atelectasis,and 6 cases had abnormal liver function.Myocardial enzyme spectrum was abnor-mal in 5 cases,and erythra was found in 2 cases.The time of fever and spasmatic cough of the glucocorticoid group was (6.7± 1.3)d and (5.35 ± 1.62)d,less than (8.3 ± 1.4)d and (7.27 ± 1.58)d of the control group(P <0.05).The length of hospital stay of glucocorticoid group and control group was (14.8 ±6.2)d and (12.8±3.3)d(P >0.05),respectively,and there was no difference between the two groups.Conclusion Se-vere mycoplasma pneumoniae pneumonia of children can lead to severe intrapulmonary infection and a variety of extrapulmonary complications.Early use the glucocorticoids can result in good effect.