儿童肺炎支原体肺炎急性期气道粘膜损害与预后的关系.docVIP

儿童肺炎支原体肺炎急性期气道粘膜损害与预后的关系 罗征秀，罗 健，徐秀娟，李渠北，唐 文，刘玉琳，袁小平，刘恩梅，符 州 （400014 重庆，重庆医科大学附属儿童医院呼吸中心） [摘要]目的 探讨儿童肺炎支原体肺炎急性期气道粘膜损害与预后的关系。方法 以2007年7月至2010年7月在重庆医科大学附属儿童医院诊断为肺炎支原体肺炎、并于急性期行纤维支气管镜检查的住院患儿为研究对象，随访患儿肺部炎症吸收情况，依据迁延性肺炎定义将其预后分为迁延性肺炎组和非迁延性肺炎组，分析肺炎支原体肺炎急性期气道粘膜损害与预后的关系。结果 93例肺炎支原体肺炎患儿纳入研究，其中19例演变为迁延性肺炎。急性期气道粘膜滤泡样增生、粘膜粗糙、充血肿胀、纵行皱褶和粘液性分泌物增多等发生率在迁延性肺炎组和非迁延性肺炎组无统计学差异（P＞0.05）；急性期粘液栓阻塞、支气管开口管腔(7/19例 vs 7/74例，15/19例 vs 12/74例；P0.05)；急性期出现肉芽组织增生、管腔闭塞、气道粘膜糜烂等改变者均演变为迁延性肺炎。结论 急性期气道粘膜严重损害可能是肺炎支原体肺炎病程迁延的重要影响因素。 [关键词]肺炎支原体肺炎；纤维支气管镜；气道粘膜损害；儿童 [中图法分类号] [文献标志码] A The relations between airway mucosal lesions and prognosis in children with mycoplasma pneumoniae pneumonia Luo Zhengxiu, Luo Jian, Xu Xiujuan, Li Qubei, Tang Wen, Liu Yulin, Yuan Xiaoping, Liu Enmei, Fu Zhou （Department of Respiratory, Children’s Hospital, Chong Qing Medical University，Chongqing,400038,China） Abstract Objective To study the relations between airway mucosal lesions and prognosis in children with mycoplasma pneumoniae pneumonia. Methods We retrospectively reviewed the records of the children with mycoplasma pneumoniae pneumonia admitted to Children’s Hospital, Chongqing Medical University who had received bronchoscopy from July 2007 to July 2010. According to the prognosis of the disease，were divided into persisting mycoplasma pneumoniae pneumonia group(the process≥1 month)and the non-persisting mycoplasma pneumoniae pneumonia group(the processl month)．The relations the airway mucosal lesions and prognosis were analyzed．Results 93 children with mycoplasma pneumoniae pneumonia aged from 2 to 11 years were recruited. Among them, 19 were persisting mycoplasma pneumoniae pneumonia and 74 patients were non-persisting mycoplasma pneumoniae pneumonia. The common mucosal lesions in both groups were bronchial mucosal follicle-like hyperplasia, roughness, hyperemia, edema, microtubule reductus and increasing mucus secretion. But airway inflammatory stenosis，mucus plug blocking were more common