摘要
目的分析含有耐药菌株的难治性肺炎支原体肺炎(RMPP)患儿的临床资料,为临床治疗提供依据。方法回顾性分析109例含有耐药菌株的难治性肺炎支原体肺炎患儿的临床资料,包括性别、年龄、发热时间、住院时间、影像学表现、支气管镜下表现、病原学检测结果、临床疗效等。对入组RMPP患儿D-二聚体(DD)、乳酸脱氢酶(LDH)水平与发热时间、住院时间、白细胞计数(WBC)、C反应蛋白(CRP)水平的关系进行Pearson线性相关分析。结果109例含有耐药菌株的RMPP患儿中,单纯肺炎支原体感染53例,混合感染56例,感染的其他病毒以副流感病毒、惠普尔为主;肺炎支原体大环内酯类耐药基因位点为23S rRNA 2063(A:G);影像学表现:右肺病变54例(49.54%),左肺病变31例(28.44%),双肺病变24例(22.02%);临床疗效总有效率为74.31%。混合感染患儿WBC高于单纯肺炎支原体感染患儿,临床疗效总有效率低于单纯肺炎支原体感染患儿(P<0.05),且随访1个月治疗无效病例肺部损伤恢复慢。RMPP患儿DD、LDH水平均与发热时间、住院时间、CRP水平呈正相关(P<0.05或0.01)。结论含有耐药菌株的RMPP患儿CRP、DD及LDH水平偏高,发热时间及住院时间较长,混合感染占比较高,且混合感染患儿WBC偏高。对于发热时间较长的患儿,应早期给予可弯曲支气管镜介入治疗,明确病原,避免远期并发症的发生。
Objective To analyze the clinical data of children with refractory mycoplasma pneumoniae pneumonia(RMPP)containing drug-resistant strains in order to provide basis for clinical treatment.Methods The clinical data of109 children with RMPP containing drug-resistant strains were retrospectively analyzed,including gender,age,duration of fever,length of hospital stay,imaging findings,bronchoscopic findings,etiology,and clinical effect.Pearson linear correlation analysis was used to analyze the relationship of D dimer(DD)and lactate dehydrogenase(LDH)level with the duration of fever,length of hospital stay,white blood cell count(WBC)and C-reactive protein(CRP)level in the children.Results Among 109 children with the RMPP with drug-resistant strains,53 were infected with mycoplasma pneumoniae simplex and 56 mixed infection,and other infected viruses were mainly parainfluenza and Whipple virus;drug-resistance genetic loci of pneumoniae macrolide was 23S rRNA 2063(A:G);imaging findings:54 children(49.54%)had right lung lesions,31(28.44%)left lung lesions,and 24(22.02%)double lung lesions;clinical total effective rate was 74.31%.The WBC was higher and clinical total effective rate lower in children with mixed infection than in ones with mycoplasma pneumoniae simplex infection(P<0.05),the recovery of lung injure of treatment failure cases within 1 month follow-up was slow.Both the DD and LDH were positively correlated with the duration of fever,length of hospital stay and CRP level in RMPP children(P<0.05 or 0.01).Conclusion The CRP,DD and LDH level are higher in children with RMPP with drug-resistant strains,the duration of fever and length of hospital stay increase,and the proportion and the WBC of children with mixed infection are higher.With the prolonging of duration of fever,interventional therapy with flexible bronchoscopy should be conducted and causes identified as earlier as possible to avoid the occurrence of long-term complications.
作者
孟永胜
刘亚娜
石欢欢
石宏
Meng Yongsheng;Liu Yana;Shi Huanhuan;Shi hong(Kaifeng Central Hospital,Kaifeng 475000,Henan,China)
出处
《临床心身疾病杂志》
2025年第3期103-106,共4页
Journal of Clinical Psychosomatic Diseases
基金
开封市科技发展计划项目(编号1803021)。
关键词
难治性肺炎支原体肺炎
儿童
可弯曲支气管镜
耐药菌株
refractory mycoplasma pneumoniae pneumonia
children
flexible bronchoscopy
drug-resistant strains
作者简介
孟永胜,男,43岁,汉族,硕士,副高级职称,河南省医院协会抗微生物药物合理应用管理分会第二届委员会常务委员,河南省高危儿管理委员会常务委员,河南省医师协会人文医学专业第二届委员会委员,河南省青春期健康与医学委员会青年委员,河南省发育性残疾防控专业委员会委员。主要研究成果:主持市厅级科研课题1项,发表专业论文9篇。研究方向:儿科呼吸系统疾病诊治。
