肺炎支原体、肺炎衣原体感染与儿童慢性咳嗽相关性分析

目的探讨肺炎支原体(Mycoplasma pneumoniae,Mp)、肺炎衣原体(Chlamydia pneumoniae,Cpn)感染与儿童慢性咳嗽(chronic cough,CC)的关系及大环内酯类药物的疗效。方法对确诊的58例CC和50名对照组儿童分别采用颗粒凝集和ELISA实验检测血浆Mp、Cpn特异性IgM抗体,并进行组间比较;同时对患儿行大环内酯类药物治疗,观察疗效。结果研究组与对照组Mp、Cpn感染情况分别是:Mp感染22例(37.9%)、9例(18.0%);Cpn感染20例(34.5%)、7例(14.0%);混合感染分别是2例(3.4%)、0例,两组比较差异有统计学意义(P<0.05)。经口服罗红霉素3～5mg/(kg·次)bid,治疗2～4周后,Mp或Cpn感染组治愈18例(45.0%),缓解10例(25.0%),治疗无效12例(30.0%),经加用泼尼松后5例(41.7%)达到有效控制。非Mp或Cpn感染组经上述治疗后有7例(38.9%)达有效控制。结论Mp或Cpn感染可能是儿童CC的主要原因,大环内酯类药物可作为有效的治疗手段。

Study of the relationship between Mycoplasma or Chlamydia pneumoniae and chronic cough in children

Objectives To investigate the role of Mycoplasma pneumoniae(Mp)or Chlamydia pneumoniae(Cpn)in the pathogenesis of chronic cough in children,and therapeutic efficacy of macrolides on chronic cough.Methods Fifty-eight children with chronic cough and 50 healthy children were enrolled in the study.The seropositivity of Mp/Cpn-IgM was measured with microparticle agglutination and enzyme-linked immunosorbent assay,respectively.The incidences of Mp/Cpn infection were coMpared between these two groups.The children with chronic cough were treated with macrolides for two to four weeks,while the children nonsensitive to macrolides were added with prednisone.Results The incidences of Mp/Cpn infection were significantly higher in study group than in control group.Of the infected group,22 cases(37.9%)showed Mp-IgM positive,20 cases(34.5%)showed Cpn-IgM positive,and 2(3.4%)with Mp and Cpn coinfection.However,the positive rate of Mp-IgM and Cpn-IgM in the control group was 9(18%)and 7(14%),respectively,with none of them having Mp and Cpn coinfection(all,P < 0.05=.After treated with macrolides,18(45.0%)children were cured,10(25.0%)relieved,and 12(30.0%)unchanged in 40 children with Mp/Cpn infection,and 7 children(38.9%)without Mp/Cpn infection were also relieved.Prednisone was added on the children non-sensitive to macrolides,of whom 5(41.7%)were relieved.Conclusions Mp/Cpn infection might be predominant pathogens of chronic cough.Macrolides could be a favorable choice for treatment of chronic cough.