中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
33期
12-15
,共4页
陈伟民%周熙惠%罗兴育%弋惠茹
陳偉民%週熙惠%囉興育%弋惠茹
진위민%주희혜%라흥육%익혜여
肺泡灌洗液%肺炎支原体%肺炎%儿童
肺泡灌洗液%肺炎支原體%肺炎%兒童
폐포관세액%폐염지원체%폐염%인동
Bronchoalveolar lavage fluid%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67例肺炎支原体肺炎患儿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,21例),中等菌量组(103 ～ 106/ml,22例)和高菌量组(＞106/ml,24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 高菌量组总热程[(12.4±2.7)d]明显比低菌量组[(7.4±2.6)d]及中等菌量组[(10.0±2.4)d]更长,且高热患儿更多,使用大环内酯类后热程也更长[(10.8±4.4),(8.5±2.4),(4.2±1.0)d],差异有统计学意义(P＜0.05).三组患儿C反应蛋白分别为(34.0±10.1),(11.5±7.6),(3.0±1.4) mg/L,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58.3％(14/24),明显多于中等菌量组的22.7％(5/22)和低菌量组的14.3％ (3/21)(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％(3/22)和25.0％(6/24)(P=0.033).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67例肺炎支原體肺炎患兒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,21例),中等菌量組(103 ～ 106/ml,22例)和高菌量組(＞106/ml,24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 高菌量組總熱程[(12.4±2.7)d]明顯比低菌量組[(7.4±2.6)d]及中等菌量組[(10.0±2.4)d]更長,且高熱患兒更多,使用大環內酯類後熱程也更長[(10.8±4.4),(8.5±2.4),(4.2±1.0)d],差異有統計學意義(P＜0.05).三組患兒C反應蛋白分彆為(34.0±10.1),(11.5±7.6),(3.0±1.4) mg/L,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58.3％(14/24),明顯多于中等菌量組的22.7％(5/22)和低菌量組的14.3％ (3/21)(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％(3/22)和25.0％(6/24)(P=0.033).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,高菌量患兒病情更為嚴重.
목적 평개폐염지원체폐염환인폐포관세액병균량여림상특정적상관성.방법 응용형광실시정량PCR대67례폐염지원체폐염환인폐포관세액진행폐염지원체DNA정량검측,병근거기기인고패수분위저균량조(＜ 103/ml,21례),중등균량조(103 ～ 106/ml,22례)화고균량조(＞106/ml,24례),비교불동조환인적림상증상급주요실험실여영상학결과.결과 고균량조총열정[(12.4±2.7)d]명현비저균량조[(7.4±2.6)d]급중등균량조[(10.0±2.4)d]경장,차고열환인경다,사용대배내지류후열정야경장[(10.8±4.4),(8.5±2.4),(4.2±1.0)d],차이유통계학의의(P＜0.05).삼조환인C반응단백분별위(34.0±10.1),(11.5±7.6),(3.0±1.4) mg/L,차이유통계학의의(P=0.004).고균량조환인영상학표현위대편폐실변/불장영자58.3％(14/24),명현다우중등균량조적22.7％(5/22)화저균량조적14.3％ (3/21)(P=0.002).저균량조미견쌍측흉강적액혹대량흉강적액,중등균량조화고균량조분별위13.6％(3/22)화25.0％(6/24)(P=0.033).결론 폐염지원체폐염인동폐포관세액병균량여림상특정유일정적상관성,고균량환인병정경위엄중.
Objective To explore the relationship between bronchoalveolar lavage fluid (BALF) Mycoplasma load and clinical characteristics in children with Mycoplasma pneumoniae (MP) pneumonia.Methods MP DNA was quantitatively detected by fluorescent real-time PCR in BALF from 67 children with MP pneumonia.They were classified into three groups:low MP load group (＜ 103/ml,21 cases),moderate MP load group (103-106/ml,22 cases) and high MP load group (＞ 106/ml,24 cases).Clinical symptom,main laboratory and imaging results of children among three groups were compared.Results When compared with low MP load group and moderate MP load group,high MP load group had longer fever duration [(7.4 ± 2.6),(10.0 ± 2.4) d vs.(12.4 ± 2.7) d],longer time to normalization of temperature with macrolide administration [(4.2 ± 1.0),(8.5 ± 2.4) d vs.(10.8 ± 4.4) d],more patients with high fever,there was significant difference (P ＜ 0.05).Statistically significant difference existed in C-reactive protein among three groups [(3.0 ± 1.4),(11.5 ±7.6),(34.0 ± 10.1) mg/L] (P =0.004).Large field of consolidation or atelectasis were found in 58.3％ (14/24) of high MP load group,much higher than 22.7％ (5/22) in moderate MP load group and 14.3％ (3/21) in low MP load group.Bilateral or massive pleural effusion was not found in low MP load group,while in moderate MP load and high MP load group,they were 13.6 ％ (3/22) and 25.0％ (6/24)(P =0.033).Conclusions 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.
