不同年龄儿童肺炎支原体肺炎临床特征的差异

Differences in the clinical features of Mycoplasma pneumoniae pneumonia among children of different ages

摘要:

目的：了解不同年龄儿童肺炎支原体肺炎（MPP）的临床特征。方法：收集2010年1月至2011年12月因确诊MPP的住院患儿112例，对其临床资料进行回顾性总结分析。将所有入选患儿按年龄分为婴幼儿组（< 3岁）20例、学龄前儿童组（3岁～）41例、学龄儿童组（６～15.2岁）51例。比较不同年龄段儿童MPP的临床表现、肺部体征、全胸片及实验室检查等方面的差异。结果：婴幼儿组MPP患儿咳痰与喘息症状相对明显，发热多以低热为主，肺外表现以胃肠道症状为主，肺部体征较明显；学龄儿童组MPP患儿多表现为高热，干咳明显，多不伴喘息，肺外表现以皮损多见，肺部体征轻；学龄前组患儿临床表现介于两者之间。婴幼儿组、学龄前儿童组MPP患儿全胸片以支气管肺炎为主要表现，而学龄儿童全胸片以肺段实质浸润为主；婴幼儿组淋巴细胞计数高于学龄儿童组，学龄儿童组血CRP水平高于婴幼儿组。结论：不同年龄阶段的儿童MPP临床特征不同，尤其是婴幼儿与学龄儿童之间差异更明显。

Abstract:

OBJECTIVE: To investigate the clinical features of Mycoplasma pneumoniae pneumonia (MPP) among children of different ages. METHODS: Retrospective analysis was performed on the clinical data of 112 children who were hospitalized due to MMP between January 2010 and December 2011. The children were divided into 3 groups according to their ages: infants (<3 years; n=20), preschool-aged children (≥3 years; n=41), and school-aged children (6-15.2 years; n=51). The three groups were compared in terms of their clinical symptoms, pulmonary signs, chest X-ray findings and laboratory test results. RESULTS: The infant group presented mainly with expectoration and wheezing, accompanied by low fever. They showed gastrointestinal symptoms as the most common extra-pulmonary manifestation and had evident pulmonary signs. The majority of the school-aged children group presented with high fever and a severe dry cough, and wheezing was seen in several of them. They showed rash as the most common extra-pulmonary manifestation and had slight pulmonary signs. The symptoms of the preschool-aged children group were in between. In the infant and preschool-aged children groups, most showed bronchopneumonia on chest X-ray, while in the school-aged children group, chest X-rays mostly showed segmental parenchymatous infiltration. The infant group had a higher lymphocyte count than the school-aged children group, while the school-aged children group had a higher serum C-reactive protein level than the infant group. CONCLUSIONS: The clinical features of MPP are different among children of different ages, especially between infants and school-aged children.