摘要
目的了解大叶性肺炎与支气管肺炎在临床特点和病原学方面的差异。方法选取2005年12月-2007年12月住院的100例大叶性肺炎患儿及200例支气管肺炎患儿。入院时采血进行血清定量酶ELISA检测肺炎支原体(MP)、衣原体(CP)抗体。第2天早晨应用一次性无菌吸痰管,利用负压抽吸咽喉部未被污染的痰液,进行细菌培养,直接免疫荧光法检查呼吸道常见的7种病毒,并行MP DNA、CP DNA检查,结合临床表现及胸片特点进行分析。结果大叶性肺炎以年长儿发病为主,临床以发热、咳嗽为特点,肺部体征不明显,胸片均表现为一个肺叶炎症,以右侧为多,实验室检查显示血清MP感染阳性率为61.0%;支气管肺炎发病以婴幼儿为主,临床以咳喘及卡他症状多见,肺部以痰鸣音和喘鸣音为主,均表现为两肺的点片状阴影,病原体仍以细菌居第1位。结论支气管肺炎患儿除在好发年龄、临床及胸片特点上与大叶性肺炎患儿有明显差异外,二者的病原谱构成亦存在明显差异。支气管肺炎患儿最主要的病原体是细菌,而大叶性肺炎患儿MP感染率为61.0%,与以往传统的病菌谱发生了巨大改变,且婴幼儿MP感染率有显著增高趋势。
Objective To study the differences in clinical characteristics and etiology in bronchopneumonia and lobar pneumonia, and provide the basis for the clinical diagnosis and treatment. Methods A retrospective study was performed on 100 children with lobar pneumonia and 200 children with bronchopneamonia from Dec. 2005 to Dec. 2007. Antibodies of mycoplasma（MP） and chlamydia（CP） were detected with quantitative enzyme linked immunosorbent assay of serum samples which were collected on addmission. On the second day morning, axenic sputum samples of laryngeapharyngis at pars were collected with onetime asepsis aspiration sputum tube by negative pressure for bacterial culture, and the common seven viruses were detected with direct immunofluorescence, and MP DNA, CP DNA were detected. The results and the clinical data and the characters of sternum were analyzed. Results Lobar pneumonia was more in the eider children, and the features were fever and cough in clinic, absence in physical sign of bellow, and inflammation of one pulmonary lobe in X - ray. Sixty - one percent of childhood lobar pneumonia had MP infection in laboratory examination. But bronchopneumonia was found more in infants and young children, whose features were cotigh, dyspnea and catarrhus in clinics, wheezy phlegm and stridor in physical sign of bellow, pulmonic shadow of spot and lamellar in X - ray. Bacteria were the most common pathogen in bronchopneumonia. Conclusions Lobar pneumonia was different from bronchopneumonia in age and clinic features and sternum characters of patients, and much more different in etiology. Bacterial infection was important in bronchopneumonia. But in lobar pneumonia, MP infection occupied 61.0%, which was different from traditionaletiology. Moreo- ver,the MP infection rate in infant and young children tend to increase obviously.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2010年第4期246-247,292,共3页
Journal of Applied Clinical Pediatrics
基金
苏州社会发展科技计划项目(SS0702)
关键词
肺炎
病原学
支原体
pneumonia
etiology
mycoplasma
