CAJ | 학술논문

目的探讨肺炎支原体（MP）肺炎患者肺外并发症的分布特点及临床诊断、治疗方法。方法收集经血MP-IgM检测阳性，确诊为支原体肺炎的1100例患儿的临床资料，统计417例肺外并发症患者（并发症组）的分布临床特点及MP-DNA检出率，并与683例无并发症组相关资料进行比较；分析4年间各种并发症的发生情况；比较行纤维支气管镜（纤支镜）灌洗术和未手术患者的相关资料。结果并发症组血MP-DNA检出率、住院时间均高于无并发症组，肺外并发症以肝功能损害、皮疹、胃肠道反应多见，但较轻；脑炎、肾炎、心肌炎少见、但严重而隐匿；致命的噬血细胞性淋巴组织增生症（HLH）亦可见。纤支镜灌洗术有利于病情恢复。结论 MP肺炎肺外并发症发生率高且凶险，需要临床仔细的观察和检查，动态监测化验指标及综合治疗。
목적탐토폐염지원체（MP）폐염환자폐외병발증적분포특점급림상진단、치료방법。방법수집경혈MP-IgM검측양성，학진위지원체폐염적1100례환인적림상자료，통계417례폐외병발증환자（병발증조）적분포림상특점급MP-DNA검출솔，병여683례무병발증조상관자료진행비교；분석4년간각충병발증적발생정황；비교행섬유지기관경（섬지경）관세술화미수술환자적상관자료。결과병발증조혈MP-DNA검출솔、주원시간균고우무병발증조，폐외병발증이간공능손해、피진、위장도반응다견，단교경；뇌염、신염、심기염소견、단엄중이은닉；치명적서혈세포성림파조직증생증（HLH）역가견。섬지경관세술유리우병정회복。결론 MP폐염폐외병발증발생솔고차흉험，수요림상자세적관찰화검사，동태감측화험지표급종합치료。
Objective To investigate the distribution, clinical diagnosis and treatment methods of the extrapulmo-nary complications in children with mycoplasma pneumoniae (MP). Methods The clinical data of 1 100 patients confirmed the diagnosis of mycoplasma pneumonia and with the positive serum MP-IgM test were collected in this study. The distribu-tion and clinical characteristics and MP-DNA detection rates were compared between 417 patients with extrapulmonary com-plications and 683 cases without complications. The occurrence of various complications in a four-year period was analyzed. Clinical data were compared between fiberoptic bronchoscopy lavage group and non-surgical group. Results The MP-DNA detection rate and the length of hospital stay were higher in patients with pulmonary complications than those of patients without complications. The most common types of extrapulmonary complications were liver damage, skin rashes and gastrointestinal reactions , but less severe. Encephalitis, nephritis and myocarditis were rare complications, but severe and occult. The fatal hemophagocytic lymphohistiocytosis (HLH) was also visible in patients. Bronchoscopy lavage was conducive to the recovery of the disease. Conclusion MP pneumonia showed high incidence and risks of extrapulmonary complica-tions, which required careful clinical observation and inspection, the dynamic monitoring laboratory markers and comprehen-sive treatment as well.