小儿肺炎支原体感染调查分析

目的分析各年龄段儿童肺炎支原体（MP）感染的流行病学特征、临床特点及治疗效果。方法采用明胶凝集法检测血MP-IgM，对MP—IgM〉1：40确诊为MP感染的482例患儿进行回顾性分析。结果482例患儿中有154人（32．0％）有明确的肺炎支原体感染接触史，其中年龄〈3岁78例（50．6％），2岁以下的婴幼儿64例中有51例（79．7％）其家庭成员或带养者中至少有一人肺炎支原体抗体呈现阳性，近2周内有临床症状的有42例（65．6％）。共有223例（46．3％）伴有不同程度的肺外并发症，3岁以下的婴幼儿并发症发生率为19．2％，4岁以上患儿为51．5％。受累脏器中以消化、心血管、血液系统和皮肤多见，神经系统少见；累积两个以上器官的占28．7％。全部病例均采用综合治疗，抗菌素治疗采用阿奇霉素序贯疗法，疗程3—4周，全部患儿均痊愈出院，无明显不良反应。所有病例均随访1年，33％的患儿3个月MP—IgM滴度降至正常，52．3％于3—6个月降至正常。3个月内复发率为3．1％。结论MP感染易误诊，对于短期内病情易反复者应追问有无流行接触史，并及早进行MP-IgM检测以确诊。MP感染易出现肺外脏器受累，规范治疗可以减轻患儿的肺外损害，减少复发。

Clinical Analysis of Children with Mycoplasma Pneumoniae Infection

Objective To analyze the epidemiology and clinical characteristics of Mycoplasma Pneumoniae（MP） infection in hospitalized children of each age groups. Methods The gelatin agglutination test were used to detected the MP-IgM. The clinical data of 482 children with MP infection confirmed by MP-IgM （above 1： 40） were analyzed retrospectively. Results 154 children （32.0%） had a clear contact history of MP infection. 223 children（46.3% ） had complications from those organs except lung. The organs included alimentary system, circulatory system, blood system, skin, nervous system, etc. All children were given a complex treatment,azithromycin sequential therapy was used as anti-inflammatory treatment, the treatment course was 3 to 4 weeks and all children were cured. All patients were followed-up for one year, no adverse reaction was observed and the recurrence rate was 3.1% in three months. Conclusion MP infection is easily misdiagnosed. We should acquire the epidemic history of patients in time and test blood MP-IgM in patients with a long time fever and cough. MP infection may easily cause harms in some organ, the regular treatment can release these harm.