Miyahar Yousuke, Takayanagi Noboru, Kubota Motoko, Hara Kenichirou, Saito Hiroo, Tokunaga Daidou, Kurashima Kazuyoshi, Ubukata Mikio, Yanagisawa Tsutomu, Sugita Yutaka
Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center.
Nihon Kokyuki Gakkai Zasshi. 2006 Sep;44(9):607-12.
We investigated 90 patients with Mycoplasma pneumoniae (M. pneumoniae) pneumonia. Forty-four patients were men, 46 were women and the mean age was 43.1 years old. Twenty-nine patients were smokers and 28 had underlying diseases. As for diagnostic method, 16 were culture positive, 71 had a fourfold increase in antibody titer to M. pneumoniae, and 3 were both culture positive and had a fourfold increase in antibody titer. Regarding the degree of severity, 21 patients were classified as severe according to Japanese Respiratory Society diagnostic criteria, 11 patients were diagnosed as severe according to American Thoracic Society diagnostic criteria. Partial pressure of arterial oxygen (PaO2) of 18 patients were <60mmHg, 5 patients were under mechanical ventilation, and 3 patients died. Three of 16 patients treated with only beta-lactum antibiotics recovered. The 3 patients who died were M. pneumoniae culture-positive and two patients had polymicrobial infections. Severe pneumonia associated with Mycoplasma pneumoniae infection is not unusual. If a rapid diagnosis kit or culture method of M. pneumoniae pneumonia is not introduced, the pathogen might be unknown in cases of rapid death due to M. pneumoniae pneumonia. These data suggest that the mortality rate of M. pneumoniae pneumonia might be underestimated without these detection tests.
我们调查了90例肺炎支原体肺炎患者。其中男性44例，女性46例，平均年龄43.1岁。29例患者为吸烟者，28例有基础疾病。诊断方法方面，16例培养阳性，71例肺炎支原体抗体滴度呈四倍增高，3例培养阳性且抗体滴度呈四倍增高。关于严重程度，根据日本呼吸学会诊断标准，21例患者被分类为重症；根据美国胸科学会诊断标准，11例患者被诊断为重症。18例患者的动脉血氧分压（PaO2）<60mmHg，5例患者接受机械通气，3例患者死亡。仅接受β-内酰胺类抗生素治疗的16例患者中有3例康复。死亡的3例患者肺炎支原体培养阳性，2例患者有混合感染。肺炎支原体感染相关的重症肺炎并不少见。如果不采用肺炎支原体肺炎的快速诊断试剂盒或培养方法，在因肺炎支原体肺炎快速死亡的病例中病原体可能无法明确。这些数据表明，没有这些检测方法，肺炎支原体肺炎的死亡率可能被低估。
