CAJ | 학술논문

目的：探讨难治性肺炎支原体肺炎合并血栓形成的临床特点和诊断、治疗要点。方法回顾性分析1例难治性肺炎支原体肺炎合并下肢静脉血栓形成以及肺栓塞的病例资料。结果患儿以呼吸道症状起病，在抗感染治疗的过程中出现下肢肿痛和左肺呼吸音减低，经检查明确下肢静脉血栓形成和肺栓塞，伴抗心磷脂抗体阳性，经甲基泼尼松龙、丙种球蛋白抑制炎症反应，低分子肝素、华法林抗凝，阿司匹林抗凝的综合治疗，患儿症状、体征明显好转。结论难治性肺炎支原体肺炎合并血栓形成可能与过度炎症反应和内皮损伤有关。临床上对于难治性肺炎支原体肺炎合并有抗磷脂抗体阳性和蛋白C浓度降低的患儿，需要警惕合并血栓形成的可能性，应尽早使用糖皮质激素和丙种球蛋白治疗。
목적：탐토난치성폐염지원체폐염합병혈전형성적림상특점화진단、치료요점。방법회고성분석1례난치성폐염지원체폐염합병하지정맥혈전형성이급폐전새적병례자료。결과환인이호흡도증상기병，재항감염치료적과정중출현하지종통화좌폐호흡음감저，경검사명학하지정맥혈전형성화폐전새，반항심린지항체양성，경갑기발니송룡、병충구단백억제염증반응，저분자간소、화법림항응，아사필림항응적종합치료，환인증상、체정명현호전。결론난치성폐염지원체폐염합병혈전형성가능여과도염증반응화내피손상유관。림상상대우난치성폐염지원체폐염합병유항린지항체양성화단백C농도강저적환인，수요경척합병혈전형성적가능성，응진조사용당피질격소화병충구단백치료。
Objective To investigate clinical features, diagnosis, and treatment of refractory Mycoplasma pneumoniae pneumonia (MPP) combined with thrombosis. Methods One case with refractory MPP associated with thrombosis was retrospectively analyzed with literature review. Results The patient presented with respiratory symptom at the onset, while melosalgia and decreased respiratory sound in left lung were occurred during anti-infection therapy. Thereafter, thrombosis of lower extremity veins and pulmonary embolism were confirmed by a series of examinations. Serum anti-phospholipid antibody was positive. Finally, the patient was treated with a combination of anticoagulation and immunosuppressive therapies. Conclusions The mechanism of refractory MPP combined with thrombosis may be associated with excessive inflammatory response and endothelial cells injury. The thrombosis complication should be suspected in patient of Mycoplasma pneumonia infection with positive anti-phospholipid antibody and low concentration of protein C and immunosuppressive therapy should be implemented promptly.