儿童肺炎支原体肺炎240例临床分析

目的探讨儿童肺炎支原体肺炎（MPP）的临床特点及治疗方法。方法对240例确诊为MPP患儿的临床资料进行回顾性分析。240例MPP患儿随机分为两组,治疗组给予阿奇霉素10 mg/kg.d静滴治疗5 d后停7 d,改用阿奇霉素口服,服3 d停4 d总疗程3周;对照组给予红霉素40 mg/kg.d静滴7 d后改口服红霉素,总疗程3周。结果本组患儿以学龄儿童为主。发热203例（84.58%）,持续性咳嗽192例（80.00%）。多数肺部可闻及湿罗音。肺外并发症主要为消化系统、心血管系统、中枢神经系统和泌尿系统损害。血清肺炎支原体特异性IgM抗体（MP-IgM）均阳性。治疗7 d后疗效比较：治疗组有效率96.7%,对照组有效率61.7%。结论儿童MPP好发于学龄儿童,肺外并发症可累及多个系统,血清学MP-IgM检测是早期诊断的必要手段,应用阿奇霉素治疗明显优于红霉素,疗效显著,且消化道反应轻。

Clinical Analysis of 240 Children with Mycoplasma pneumoniae Pneumonia

Objective To study the clinical characteristics and treatment of children with Mycoplasma pneumoniae pneumonia(MPP).Methods The clinical data of 240 children with MPP were analyzed retrospectively.240 MPP children were randomly divided into two groups.The treatment group was received azithromycin(10 mg/kg·d) by intravenous drips in the first five days,after 7 days,orally took azithromycin for 3 days.The control group was given erythromycin(40 mg/kg·d) by intravenous drips in the first seven days and then orally took erythromycin.The treatment courses of the two groups were both 3 weeks.Results The majority cases aged between 6 to 12 years.There were 203 cases with fever(84.58%) and 192 cases with persistent cough(80.00%).There were moist rales heard over the lungs in the majority cases.The extrapulmonary complications occurred mainly in the digestive system,cardiovascular system,central nervous system,and urinary system.All the cases showed a positive serum Mycoplasma pneumoniae IgM(MP-IgM).After 7 days of treatment,the effective rates of azithromycin group and control group were 96.7% and 61.7%,respectively.Conclusions Most of MPP children are preschoolers.The extrapulmonary complications can occur in multiple systems.The test of serum MP-IgM should be conducted for early diagnosis.The therapeutic effect of azithromycin in children with MPP is superior to that of erythromycin,and with less adverse reactions.