儿童嗜肺军团菌肺炎合并肺炎支原体感染的临床研究-第三军医大学学报.DOCVIP

儿童嗜肺军团菌肺炎合并肺炎支原体感染的临床研究 何志慧， 周玉福， 石远滨 （400700重庆，重庆市第九人民医院儿科） 【摘 要】 目的 对儿童嗜肺军团菌(Legionella pneumophila, Lp)肺炎合并肺炎支原体(Mycoplasma pneumoniae，MP)感染的临床特征进行研究总结，为临床防治积累资料 。 方法 收集本院2010年1月～2012年1月收治的225例Lp感染、其中有98例合并MP感染的肺炎患儿的临床资料，对其临床特征作回顾性对比分析。结果 LP与MP混合感染所致儿童肺炎多见于城镇学龄前期儿童, 与单独LP感染肺炎组比较：混合感染组多表现为热峰高、热程长，出现肺部阳性体征、心率增快、颈淋巴结肿大和肝脏增大的发生例数显著增多，差异有统计学意义（P0.05）；辅助检查出现胸片大片斑片影及胸腔积液表现，出现WBC增高、CRP增高、心电图阳性表现（心动过速／ST-T改变）、CK-MB增高、肝功异常的例数显著增多，差异有统计学意义（P0.05）；所需治疗时间显著延长，差异有统计学意义（P0.05）。结论 儿童LP肺炎合并 MP混合感染可群体发病，常表现为肺部症状体征重、更易合并肺外多器官及多系统的损害。应积极开展大样本、多中心的研究以获得我国感染现状的可靠资料，从而为临床防治提供思路和对策。 【关键词】儿童 嗜肺军团菌 肺炎支原体 肺炎 The clinical research of childhood legionella pneumophila pneumonia combined with mycoplasma pneumoniae infection HE Zhihui, ZHOU Yufu , SHI Yuanbing (Department of Pediatrics, The Ninth People’s Hospital of Chongqing, Chongqing 400700, China) [Abstract] Objective To summarize the clinical features of childhood legionella pneumophila pneumonia (Lp) combined with mycoplasma pneumoniae (Mp) infection ,to accumulate materials for the clinical prevention and treatment. Methods Clinical data of 255 cases infected with childhood legionella pneumophila pneumonia (in which 98 cases combined with Mp infection) admitted to The Ninth People’s Hospital of Chongqing from January 2010 to January 2012 were collected, and their clinical features were compared and analyzed. Results Childhood pneumonia due to LP and MP mix infection is more common in urban preschool children. Compared with the LP pneumonia group, most in mixed infection group have performance of: high thermal peak, long thermal path. And there is a significant increase in the number of cases for positive signs of lung, heart rate increase, enlargement of lymph nodes and liver (P0.05). And with auxiliary examination have performance of : large areas of plaques shadow and pleural effusion in Chest X-ray, WBC increase, CRP increase, ECG positive (tachycardia / ST-T changes), CK-MB increase, cases with liver function abnormal