1岁以下的重症肺炎支原体肺炎患儿临床特点分析

目的 了解1岁以下重症肺炎支原体肺炎患儿临床特点。方法 运用回顾性研究的方法，观察2014年1月至2016年12月福建省妇幼保健院儿童病房65例重症肺炎支原体肺炎患儿临床特点。结果 患儿均有咳嗽、气喘、肺部啰音的临床表现，各月龄组性别、机械通气比例、发热比例，住院时间(>10天)比较有差异但无统计学意义（P>0.05）；各月龄组白细胞总数、血小板计数、C反应蛋白、乳酸脱氢酶、肌酸肌酶同工酶、D 二聚体、丙氨酸氨基转移酶比较差异无统计学意义（P＞0.05）；1～3月组、4～6月组、7～9月组（或10~12月组）发热最高体温（>39 ℃），发热持续时间(≥11天)比例逐渐升高（P<0.05）；随着月龄的增大，患儿出现肺部合并症（肺不张、肺实变、肺气肿、胸腔积液）比例逐渐减少，小儿危重评分＜80分的比例逐渐减少（P<0.05），各月龄组患儿前白蛋白比较差异有统计学意义（P<0.05），以10~12月龄组最高。结论 不同年龄阶段的儿童肺炎支原体肺炎临床特征不同。月龄小，可能病情越重，肺部并发症越多，前白蛋白减低明显，月龄大，发热时间超过11天可能性越大。

Clinical characteristics of severe mycoplasma pneumoniae pneumonia in hospitalized infants younger than one year old

Objective To study the clinical characteristics of severe mycoplasma pneumoniae pneumonia (MPP) in different month age groups of infants. Methods Retrospective analysis was utilized on the clinical data of the 65 infants who were enrolled by Fujian Maternity and Children Health Hospital due to severe MPP between January 2014 and December 2016. Results All of the 65 infants had the same symptoms of cough, wheezing and rale. Among different month age groups, the proportions of male, mechanical ventilation, fever and the length of hospitalization were not significantly different. The levels of white blood cell count, platelet count (PLT) , C reactive protein, lactate dehydrogenase, MB isoenzyme of creatine kinase, D dimer and alanine aminotransferase were different but had no statistical significance; As the month age grows, the proportion of maximum body temperature (>39.0 ℃) and duration of fever (≥11 days) increased with statistical significance. The proportion of pulmonary complications（including atelectasis, emphysema, lung consolidation and hydrothorax）and Pediatric Critical Illness Score decreased with statistical significance among four groups. Prealbumin (PA) differ significantly among four groups, among which the 10 to 12 months group had a higher PA level than the others. Conclusion The clinical features of severe MPP differs among infants of different month ages. Younger infants may have greater severity of MPP, more pulmonary complications and greater reduction of prealbumin, while the elder infants have higher probability of duration of fever (≥11 days).