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儿童肺炎支原体和肺炎衣原体肺炎 - 临床特征比较分析。

Pneumonia caused by Mycoplasma pneumoniae and Chlamydophila pneumoniae in children - comparative analysis of clinical picture.

机构信息

3rd Department of Paediatrics, Polish Mother's Memorial Hospital - Research Institute, Lodz, Poland.

出版信息

Adv Med Sci. 2011;56(1):56-63. doi: 10.2478/v10039-011-0017-z.

Abstract

PURPOSE

The aim of the study was comparative analysis of clinical picture and prevalence of pneumonia caused by Mycoplasma pneumoniae and Chlamydophila pneumoniae in children.

MATERIAL AND METHODS

The study involved 332 children hospitalized in the 3rd Department of Paediatric, Polish Mother's Memorial Hospital - Research Institute, due to pneumonia caused by Mycoplasma pneumoniae - group I or Chlamydophila pneumonia - group II.

RESULTS

Over 2003-2009 period there were 1870 children hospitalized due to pneumonia, of which in 332 (17.8%) the Mycoplasma pneumoniae and/or Chlamydophila pneumoniae etiology was confirmed. Mycoplasma pneumoniae, Chlamydophila pneumoniae, and mixed infection was diagnosed in 198 (10.6%), 102 (5.5%), and 32 (1.7%) children, respectively. The dominant clinical feature in both groups was cough, observed in 186 (93.9%) and 88 (86.3%) children, respectively. Further, reddening of the throat, rhinitis, shortness of breath, fever, enlarged lymph nodes, skin lesions and dyspepsia were also observed. The frequency of specific clinical features in both groups was similar. Statistical relationship (p≤0.05) was observed only in case of skin lesions. In chest x-ray there was no statistical link as for analyzed changes. Interstitial inflammatory changes were most frequently observed.

CONCLUSIONS

Mycoplasma pneumoniae and Chlamydophila pneumoniae are significant etiological factors in pneumonia in children, and as such they should be taken into consideration in differential diagnosis of pneumonia in children. The clinical picture of pneumonia caused by Mycoplasma pneumoniae and Chlamydophila pneumoniae is hardly specific, with basic labs and chest x-ray of little help in differentiation of infection etiology.

摘要

目的

本研究旨在对肺炎支原体和肺炎衣原体引起的儿童肺炎的临床特征和流行情况进行比较分析。

材料与方法

本研究纳入了 2003 年至 2009 年期间在波兰 Mother's Memorial 医院-研究所儿科 3 科因肺炎住院的 332 名儿童,这些儿童的肺炎由肺炎支原体(I 组)或肺炎衣原体(II 组)引起。

结果

在 2003 年至 2009 年期间,有 1870 名儿童因肺炎住院,其中 332 名(17.8%)儿童的病因被确认为肺炎支原体和/或肺炎衣原体。198 名(10.6%)、102 名(5.5%)和 32 名(1.7%)儿童分别被诊断为肺炎支原体、肺炎衣原体和混合感染。两组的主要临床特征均为咳嗽,分别见于 186 名(93.9%)和 88 名(86.3%)儿童。此外,还观察到咽红、鼻炎、呼吸急促、发热、淋巴结肿大、皮肤损伤和消化不良。两组的特定临床特征的频率相似。仅在皮肤损伤的情况下观察到统计学关系(p≤0.05)。在胸部 X 光片中,没有观察到分析变化的统计学关联。最常观察到间质性炎症变化。

结论

肺炎支原体和肺炎衣原体是儿童肺炎的重要病因,因此在儿童肺炎的鉴别诊断中应考虑到这两种病原体。肺炎支原体和肺炎衣原体引起的肺炎的临床特征几乎没有特异性,基本实验室检查和胸部 X 光对鉴别感染病因帮助不大。

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