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儿童重症肺炎支原体肺炎的临床特征分析

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目的 探讨儿童重症肺炎支原体肺炎(severe mycoplasma pneumoniae pneumonia,SMPP)的临床特征。方法 回顾性收集2018年1月1日至2021年12月31日间在华中科技大学同济医学院附属同济医院儿童重症监护室住院治疗的SMPP患儿的临床资料,并分析其临床特征数据。结果 84例SMPP患儿中,72月龄最常见。年长儿组人数明显多于婴幼儿组(59us。25,P<0。05)。SMPP检出率最高的月份是7月。主要临床表现为发热、咳嗽、肺外症状。73。8%的患儿出现了肺部体征的改变,33。3%的患儿在病程中存在肺外并发症。支气管肺泡灌洗液病原宏基因组二代测序(metagenomic next-generation sequencing,mNGS)中肺炎支原体阳性率为100。0%,核酸检测的阳性率为80。5%,高于其他检测方式。年龄、入科氧流量、入院乳酸脱氢酶(lactate dehydrogenase,LDH)值是引起SMPP需要连续气道正压通气或有创呼吸机等高级呼吸支持的独立危险因素。结论 SMPP患儿发热以高热为主,发热时间长,可伴有严重肺外并发症。年龄越小的SMPP患儿其肺部病变越重。支气管肺泡灌洗液mNGS是一种快速、特异性高的诊断方法。
Clinical Characteristics of Severe Mycoplasma Pneumoniae Pneumonia
Objective To investigate the clinical characteristics of severe mycoplasma pneumoniae pneumonia(SMPP)in children.Methods Clinical data of SMPP children who were hospitalized in the pediatric intensive care unit of Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 1st,2018 to December 31st,2021 were retrospectively collected,and data of their clinical characteristics were analyzed.Results Among the 84 children with SMPP,children aged 72 months were the most common.The number of elderly group was significantly higher than that in the infant group(59 vs.25,P<0.05).July witnessed the highest SMPP detection rate.The main clinical manifestations were fever,cough and extrapulmonary symptoms.In all,73.8%of the children had changes in pulmonary signs,and 33.3%of them had extrapul-monary complications during the course of the disease.The positive rate of metagenomic next-generation sequencing(mNGS)in bronchoalveolar lavage fluid was 100.0%,and the positive rate of nucleic acid detection was 80.5%,which was higher than oth-er detection methods.Age,admitted oxygen flow,and lactate dehydrogenase(LDH)values were independent risk factors for ad-vanced respiratory support for SMPP,including CPAP and invasive ventilators.Conclusion High and long-time fever,as well as serious extrapulmonary complications are common characteristics among SMPP children.The younger the children,the more se-vere the lung lesions.Bronchoalveolar lavage with bronchoalveolar lavage solution mNGS is a rapid and highly specific diagnostic method for children with SMPP.

community-acquired pneumoniamycoplasma pneumoniaesevere mycoplasma pneumoniae pneumoniaclinical manifestationrespiratory supportchildren

戴漆、林丹彤、陈瑜

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华中科技大学同济医学院附属同济医院儿科,武汉 430030

社区获得性肺炎 肺炎支原体 重症肺炎支原体肺炎 临床表现 呼吸支持 儿童

湖北省卫生健康委员会资助项目湖北省病理生理学会资助项目

WJ2023M0042021HBAP004

2024

华中科技大学学报(医学版)
华中科技大学

华中科技大学学报(医学版)

CSTPCD北大核心
影响因子:1.443
ISSN:1672-0741
年,卷(期):2024.53(3)