CAJ | 학술논문

目的：探讨不同年龄段肺炎支原体感染患儿的临床特点。方法选取2009年2月至2012年12月我院收治的202例肺炎支原体感染的患儿，根据年龄的不同将其分为婴幼儿组、学龄前儿童组、学龄儿童组，比较三组肺炎支原体感染患儿的临床特点。结果婴幼儿组患儿临床特征以咳嗽、咳痰以及喘息为主，分别占80.56%和52.78%，69.44%的患儿肺部听诊可闻及干湿性啰音，肺外表现以胃肠道表现较为多见，发生率为36.11%，77.28%的患儿胸片提示出现支气管肺炎；学龄儿童组76.92%的患儿可出现体温>39℃的表现，仅有28.57%的患儿出现咳嗽、咳痰症状，5.49%的患儿出现喘息，20.88%的患儿出现肺部干湿性啰音，肺外表现以皮损较为常见，发生率为13.19%，而胃肠道表现不甚明显，发生率仅为7.69%，仅有25.27%的患儿胸部X线片提示为支气管肺炎；学龄前儿童组的临床特征介于婴幼儿组与学龄儿童组之间。三组患儿的临床特征、淋巴细胞计数以及血CRP水平等情况比较差异均具有统计学意义(P<0.05)。202例MP感染患儿中有44例出现单份血清MP-IgM≥1：80，以学龄前儿童出现最多，24例，占32%；128例出现双份血清MP-IgM阴性转阳性，婴幼儿组出现28例，占77.78%；30例出现MP-IgM增高至少4倍情况，以学龄儿童出现最多，20例，占21.98%。结论不同年龄段肺炎支原体感染患儿的临床特征各有其不同的特点，主要可能是由于肺部损伤机制的不同所导致。
목적：탐토불동년령단폐염지원체감염환인적림상특점。방법선취2009년2월지2012년12월아원수치적202례폐염지원체감염적환인，근거년령적불동장기분위영유인조、학령전인동조、학령인동조，비교삼조폐염지원체감염환인적림상특점。결과영유인조환인림상특정이해수、해담이급천식위주，분별점80.56%화52.78%，69.44%적환인폐부은진가문급간습성라음，폐외표현이위장도표현교위다견，발생솔위36.11%，77.28%적환인흉편제시출현지기관폐염；학령인동조76.92%적환인가출현체온>39℃적표현，부유28.57%적환인출현해수、해담증상，5.49%적환인출현천식，20.88%적환인출현폐부간습성라음，폐외표현이피손교위상견，발생솔위13.19%，이위장도표현불심명현，발생솔부위7.69%，부유25.27%적환인흉부X선편제시위지기관폐염；학령전인동조적림상특정개우영유인조여학령인동조지간。삼조환인적림상특정、림파세포계수이급혈CRP수평등정황비교차이균구유통계학의의(P<0.05)。202례MP감염환인중유44례출현단빈혈청MP-IgM≥1：80，이학령전인동출현최다，24례，점32%；128례출현쌍빈혈청MP-IgM음성전양성，영유인조출현28례，점77.78%；30례출현MP-IgM증고지소4배정황，이학령인동출현최다，20례，점21.98%。결론불동년령단폐염지원체감염환인적림상특정각유기불동적특점，주요가능시유우폐부손상궤제적불동소도치。
Objective To investigate the different clinical features of mycoplasma pneumoniae infection in children with different ages. Methods 202 children with mycoplasma pneumoniae infection admitted to our hospital from February 2009 to December 2012 were enrolled and divided into infant group, preschool group and school age group according to the age. The clinical features of mycoplasma pneumoniae infection were compared among three groups. Results In infants group, the clinical features were mainly characterized as coughing, sputum and wheezing, accounting for 80.56%and 52.78%, respectively. Wet and dry rales were auscultated in 69.44%children. Besides, gas-trointestinal manifestations were common to be observed in the children with a rate of 36.11%. 77.28% children showed bronchial pneumonia in Chest X-ray. In school age group, 76.92%children showed a body temperature higher than 39℃. Among the children, only 28.57%with coughing, sputum, 5.49%with wheezing, 20.88%with wet and dry rales were found. The skin lesion was a common manifestation with a rate of 13.19%, while the symptoms of the gas-trointestinal tract with a rate of 7.69%were not obvious. Only 25.27%children were diagnosed as bronchial pneu-monia in chest X-ray. The clinical features of preschool group were between infants and school age group. The dif-ferences in the clinical features, blood lymphocyte count and CRP levels among the three groups were statistically significant (P<0.05). Serum MP-IgM level of 1:80 and above was detected in 44 of 202 cases with MP infection, where the preschoolers accounted mostly for 32%of 24 cases. A converting from negative to positive was observed in 128 cases of paired serum MP-IgM, where the infant group accounted for 77.78%of 28 cases, and an increasing of least 4-fold in MP-IgM were found in 30 cases, where the school age group accounted for 21.98%with 20 cases. Conclusion Mycoplasma pneumoniae infection in children with different ages shows different clinical features, which mainly due to different mechanisms in lung injury.