儿童难治性肺炎支原体肺炎的临床分析-儿科学专业论文.docxVIP

儿童难治性肺炎支原体肺炎的临床分析 研究生：李金艳 导师：多力坤 副教授 摘 要 目的： 探讨儿童难治性肺炎支原体肺炎 (refractory mycoplasma pneumoniae pneumonia,RMPP)的免疫功能和肺部影像学变化及治疗问题。方法：选择2008年12 月-2010年12月在儿内科住院的RMPP患儿62例。按照随机对照研究方法将患儿分为 两组即激素组和非激素组（每组各31例），同期选择门诊健康体检儿童40例作为健康 对照组，统计各项临床资料并进行对比分析。结果：(1)RMPP组IgG、IgM、CD3+/CD8+ 值较对照组均升高有统计学差异(P0.05)。RMPP组CD3+T细胞、CD3+/CD4+值、 CD4+/CD8+值、T细胞活化后CD3+/CD25+细胞的表达率与对照组比较均降低，有统计 学差异(P0.05)。(2)激素组在热程、住院天数、抗生素使用天数、病情反复次数较非 激素组均明显降低，有统计学意义(P0.05)。而且激素组临床症状和影像学肺部病变 较非激素组好转较快，有统计学差异(P0.05)。结论：难治性肺炎支原体肺炎的发病 机制可能与机体免疫因素有关。HRCT检查更有助于明确病变范围，客观反映治疗后 的变化，判断疾病的转归。使用糖皮质激素可以缩短病程并减少复发。 关键词：难治性肺炎支原体肺炎；糖皮质激素；儿童 The clinic analysis of refractory mycoplasma pneumoniae pneumonia in children Postgraduate: Li Jinyan Supervisor: Vice Prof.Duo Likun Abstract Objectives:To investigate the immune function changes,imaging changes and treatment of refractory mycoplasma pneumoniae pneumonia. Methods: The clinical data of 62 children with RMPP were reviewed from December 2008 to Dcember 2010 in our department.According to the randomized control study,the subjects were divided into two groups,corticosteroid group(31 cases) and the non-corticosteroid group(31 cases);In the same period 40 outpatient healthy children were considered as contol group;The clinical data was compared between the groups.Results:The levels of serum IgG and IgM, the ratio of CD3+/CD8+,from RMPP children, were significantly statistical higher than those from control group (P0.05). The percentage of CD3+ cell, the ratio of CD3+/CD4+, the ratio of CD4+/CD8+, the expression of CD3+/CD25+ on T cell, from RMPP children,were significantly statistical lower than those from control group (P0.05). The fever days,total hospital days, antibiotic use days, the number of repeated illness, from Hormone group children, were significantly statistical lower than those from non- hormone group(P0.05). And the Hormone group children statistical rapidly improved clinical symptoms, imaging showed statisticaly fast improvement in lung disease(P0.05).Conclusions