Wang Zhen, Li Ya-Chun, Chen Lu
Department of Pediatrics, Shanghai Jiaotong University Affiliated First People's Hospital, Shanghai 201600, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2015 Nov;17(11):1189-92.
To investigate the clinical indicators for early identification of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children.
The clinical data of 142 children with Mycoplasma pneumoniae pneumonia (MPP) between January 2014 and June 2015 were retrospectively studied. Among the 142 children, there were 32 cases of RMPP and 110 cases of non-refractory MPP. The clinical data were compared between the RMPP and non-refractory MPP groups.
The percentage of school-age children in the RMPP group was higher than in the non-refractory MPP group (P<0.05). The mean onset age in the RMPP group was older than the non-refractory MPP group (P<0.05). Steroid was used in 93.8% of RMPP children compared with 7.3% of non-refractory MPP children (P<0.001). Consolidation of lung on chest X-Ray was shown in 87.5% of RMPP children compared with 42.7% of non-refractory MPP children (P<0.001). The incidence of pleural effusion in the RMPP group was higher than in the non-refractory MPP group (P<0.001). The RMPP group had higher percentages of individuals with CRP>40 mg/L and ESR>30 mm/h+LDH>300 IU/L than the non-refractory MPP group (P<0.05).
RMPP is common in school-age children. Consolidation of lung on chest X-Ray, pleural effusion and increased levels of CRP and ESR+LDH may be helpful to early identification of RMPP in children.
探讨儿童难治性支原体肺炎（RMPP）早期识别的临床指标。
回顾性研究2014年1月至2015年6月期间142例支原体肺炎（MPP）患儿的临床资料。142例患儿中，难治性MPP 32例，非难治性MPP 110例。比较RMPP组和非难治性MPP组的临床资料。
RMPP组学龄儿童的比例高于非难治性MPP组（P<0.05）。RMPP组的平均发病年龄大于非难治性MPP组（P<0.05）。93.8%的RMPP患儿使用了类固醇，而非难治性MPP患儿的这一比例为7.3%（P<0.001）。87.5%的RMPP患儿胸部X线显示肺部实变，而非难治性MPP患儿的这一比例为42.7%（P<0.001）。RMPP组胸腔积液的发生率高于非难治性MPP组（P<0.001）。RMPP组CRP>40 mg/L和ESR>30 mm/h+LDH>300 IU/L的个体比例高于非难治性MPP组（P<0.05）。
RMPP在学龄儿童中常见。胸部X线肺部实变、胸腔积液以及CRP和ESR+LDH水平升高可能有助于儿童RMPP的早期识别。
