摘要
目的探讨肺炎支原体（MP）肺炎呈大叶性肺炎改变的临床特征和诊断要点。方法对本院呼吸科2004年1月-2005年12月收住的21例临床具有呼吸道症状和体征,胸片提示为大叶性肺炎改变,下呼吸道分泌物聚合酶链反应（PCR）MP检测阳性和（或）间接血凝法MP-IgM阳性的MP肺炎患儿的临床资料进行回顾性分析。结果MP肺炎呈大叶性肺炎改变者临床与肺炎链球菌病原感染相似,有以下特点：1.大叶性MP肺炎仍以学龄期儿童多见;2.病程长,呼吸道症状突出,稽留高热少见,感染中毒症状不如肺炎链球菌肺炎明显;3.肺外损害多见且突出;4.白细胞总数和中性粒细胞及C反应蛋白（CRP）升高不如肺炎链球菌明显,肺部病灶的吸收相对较快;5.β-内酰胺类抗生素治疗无效,大环内酯类治疗有效。结论需掌握MP肺炎的临床特征,注意MP肺炎胸片改变的多样性,并与其他病原感染的大叶性肺炎相鉴别。
Objective To explore the clinical characteristics and diagnosis of mycoplasma pneumoniae（MP） pneumonia showing lobar pneumonia.Methods Patients from Jan.2004 to Dec.2005 were selected as researching case,which had samptoms and signs of respiratory in clinic,the chest Xray shown lobar pneumonia,the MP of down respiratory′s secretion detected by polymerase chain reaction（PCR） and MP-IgM of serum detected by indirect hemagglutination were positive.The clinical data of them were reviewed.Results MP pneumonia showing lobar pneumonia was same to streptococcus pneumoniae pneumonia in clinic,but it had some characters：1.majority of the lobar MP pneumonia were children being student,2.the process was long,the samptoms of respiratory was tipical,the continuous fever was few,and the infectious samptoms was not obvious as streptococcus pneumoniae pneumonia,3.the injury to lung was more and tipical,4.the increase of white blood cell,neutrocyte and C-reactive protein were not clearly as to streptococcus pneumoniae pneumonia,but the absorbing of lung′s focal was relatively fast,5.the β-lactams antibiotic was not effective,but macrolides was effective.Conclusions Clinical characters of MP pneumonia are needed to master,the variety of chest X-ray changes and differentiate from other pneumonia infected by other are needed to notice.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2007年第4期285-286,共2页
Journal of Applied Clinical Pediatrics
关键词
肺炎支原体
大叶性肺炎
临床
特征
mycoplasma pneumoniae,lobar pneumonia,clinic,character
