中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2013年
10期
736-740
,共5页
成云改%李淑娴%李雪静%陈颖%陈志敏
成雲改%李淑嫻%李雪靜%陳穎%陳誌敏
성운개%리숙한%리설정%진영%진지민
肺炎支原体%肺炎%儿童
肺炎支原體%肺炎%兒童
폐염지원체%폐염%인동
Mycoplasma pneumoniae%Pneumonia%Child
目的 评价肺炎支原体肺炎患儿肺泡灌洗液病菌量与临床特征的相关性.方法 应用荧光实时定量PCR对77例肺炎支原体肺炎患几肺泡灌洗液进行肺炎支原体DNA定量检测,并根据其基因拷贝数分为低菌量组(＜ 103/ml,14例),中等菌量组(103 ～ 106/ml,22例)和高菌量组(＞106/ml,41例),比较不同组患儿的临床症状及主要实验室与影像学结果.结果 与低菌量组(7 d)及中等菌量组(10 d)相比,高菌量组患儿(12 d)总热程更长,高热患儿(50.0％、68.2％、87.8％)更多,使用大环内酯类热退时间(4d、8d、10 d)也更长,热程≥10 d者分别为35.7％,50％和73.2％(P均＜0.05).三组患儿C反应蛋白(mg/L) (1.0、11.5、34)比较差异有统计学意义(P=0.004).高菌量组患儿影像学表现为大片肺实变/不张影者58.5％,明显多于中等菌量组(22.7％)和低菌量组(14.3％)(P=0.002).低菌量组未见双侧胸腔积液或大量胸腔积液,中等菌量组和高菌量组分别为13.6％和24.4％ (P =0.033).高菌量组不同年龄患儿临床症状、主要实验室与影像学结果比较差异无统计学意义(P均＞0.05).结论 肺炎支原体肺炎儿童肺泡灌洗液病菌量与临床特征有一定的相关性,高菌量组患儿病情更为严重.
目的 評價肺炎支原體肺炎患兒肺泡灌洗液病菌量與臨床特徵的相關性.方法 應用熒光實時定量PCR對77例肺炎支原體肺炎患幾肺泡灌洗液進行肺炎支原體DNA定量檢測,併根據其基因拷貝數分為低菌量組(＜ 103/ml,14例),中等菌量組(103 ～ 106/ml,22例)和高菌量組(＞106/ml,41例),比較不同組患兒的臨床癥狀及主要實驗室與影像學結果.結果 與低菌量組(7 d)及中等菌量組(10 d)相比,高菌量組患兒(12 d)總熱程更長,高熱患兒(50.0％、68.2％、87.8％)更多,使用大環內酯類熱退時間(4d、8d、10 d)也更長,熱程≥10 d者分彆為35.7％,50％和73.2％(P均＜0.05).三組患兒C反應蛋白(mg/L) (1.0、11.5、34)比較差異有統計學意義(P=0.004).高菌量組患兒影像學錶現為大片肺實變/不張影者58.5％,明顯多于中等菌量組(22.7％)和低菌量組(14.3％)(P=0.002).低菌量組未見雙側胸腔積液或大量胸腔積液,中等菌量組和高菌量組分彆為13.6％和24.4％ (P =0.033).高菌量組不同年齡患兒臨床癥狀、主要實驗室與影像學結果比較差異無統計學意義(P均＞0.05).結論 肺炎支原體肺炎兒童肺泡灌洗液病菌量與臨床特徵有一定的相關性,高菌量組患兒病情更為嚴重.
목적 평개폐염지원체폐염환인폐포관세액병균량여림상특정적상관성.방법 응용형광실시정량PCR대77례폐염지원체폐염환궤폐포관세액진행폐염지원체DNA정량검측,병근거기기인고패수분위저균량조(＜ 103/ml,14례),중등균량조(103 ～ 106/ml,22례)화고균량조(＞106/ml,41례),비교불동조환인적림상증상급주요실험실여영상학결과.결과 여저균량조(7 d)급중등균량조(10 d)상비,고균량조환인(12 d)총열정경장,고열환인(50.0％、68.2％、87.8％)경다,사용대배내지류열퇴시간(4d、8d、10 d)야경장,열정≥10 d자분별위35.7％,50％화73.2％(P균＜0.05).삼조환인C반응단백(mg/L) (1.0、11.5、34)비교차이유통계학의의(P=0.004).고균량조환인영상학표현위대편폐실변/불장영자58.5％,명현다우중등균량조(22.7％)화저균량조(14.3％)(P=0.002).저균량조미견쌍측흉강적액혹대량흉강적액,중등균량조화고균량조분별위13.6％화24.4％ (P =0.033).고균량조불동년령환인림상증상、주요실험실여영상학결과비교차이무통계학의의(P균＞0.05).결론 폐염지원체폐염인동폐포관세액병균량여림상특정유일정적상관성,고균량조환인병정경위엄중.
Objective Mycoplasma pneumoniae (MP) is an important pathogen for communityacquired pneumonia in children.MP infection was considered to be self-limited,but many severe refractory MP pneumonia cases have been reported in recent years.The reason for variation in severity of MP pneumonia remains unclear.MP virulence including drug-resistance and host immunologic function are important influencing factors.The present study aimed to clarify relationship between local MP load and severity of MP pneumonia.Method MP DNA was quantitatively detected by fluorescent real-time PCR in bronchoalveolar lavage fluid (BALF) from 77 children with MP pneumonia.They were classified into groups of low MP load (＜ 103/ml,n =14),moderate MP load(103-106/ml,n =22) and high MP load(＞ 106/ml,n =41).Clinical symptoms,main laboratory and imaging results of children among the three groups were compared.Result When compared with low load group and moderate load group,high load group had longer fever duration (7 d,10 d vs.12 d),longer time to normalization of temperature with macrolide administration(4 d,8 d vs.10 d),more patients with high fever(50.0％,68.2％ vs.87.8％) and longer duration of fever than 10 d (35.7％,50.0％ vs.73.2％).Statistically significant difference existed in CRP among the three groups (1.0 mg/L,11.5 mg/L,34 mg/L).Large field of consolidation or atelectasis were found in 58.5％ of high load patients,much higher than 22.7％ in moderate load and 14.3％ in low load patients.Bilateral or massive pleural effusion was not found in low load group,while in moderate load and high load group,they were 13.6％ and 24.4％.However,no significant difference was found in symptoms and main laboratory and imaging results among different age groups in high load patients.Conclusion There is a close relationship between MP load in BALF and clinical characteristics in children with MP pneumonia.Those with high MP load have a more severe process.
