Saraya Takeshi, Watanabe Takayasu, Tsukahara Yayoi, Ohkuma Kosuke, Ishii Haruyuki, Kimura Hirokazu, Yan Kunimasa, Goto Hajime, Takizawa Hajime
Department of Respiratory Medicine, Kyorin University School of Medicine, Japan.
Department of Radiology, Kyorin University School of Medicine, Japan.
Intern Med. 2017 Nov 1;56(21):2845-2849. doi: 10.2169/internalmedicine.8500-16. Epub 2017 Sep 25.
Objective To compare the radiological and laboratory data of children and adults with Mycoplasma pneumoniae pneumonia (MPP) and to evaluate the correlation between the total affected lung area and the clinical findings. Methods We retrospectively examined the data from MPP patients who visited our hospital during the period from April 2006 to July 2014. All data were retrieved at the time of the diagnosis of MPP and were analyzed to investigate the correlation between the clinical findings and the total affected lung area using a chest X-ray scoring system. Results We identified 71 children and 54 adults with MPP. The incidence of consolidation, which was the most common chest X-ray finding in both groups, was similar (children: n = 62, 87.3%; adults: n = 45, 83.3%). In contrast, air bronchogram, bronchial thickening, and atelectasis were observed significantly more frequently among children than among adults. In both groups, a chest X-ray scoring system revealed a zonal predominance of the affected area (middle-to-lower lung fields). The body temperature and serum data such as the C-reactive protein level, white blood cell count, and lactate dehydrogenase level were significantly higher in the child group than in the adult group. The total score did not significantly correlate with the above-mentioned inflammatory markers or the presence of hypoxemia in either group. Conclusion This study showed the first evidence of a correlation between the extent of lung abnormalities on chest X-ray (calculated as a total score) and the clinical findings, including the presence of hypoxemia, in children and adults with MPP.
目的 比较儿童和成人支原体肺炎（MPP）的影像学和实验室数据，并评估肺部总受累面积与临床症状之间的相关性。方法 我们回顾性研究了2006年4月至2014年7月期间来我院就诊的MPP患者的数据。所有数据均在MPP诊断时获取，并使用胸部X线评分系统分析临床症状与肺部总受累面积之间的相关性。结果 我们确定了71例儿童和54例成人MPP患者。实变是两组中最常见的胸部X线表现，其发生率相似（儿童：n = 62，87.3%；成人：n = 45，83.3%）。相比之下，儿童中空气支气管征、支气管增厚和肺不张的观察频率明显高于成人。在两组中，胸部X线评分系统显示受累区域以肺野中下部为主。儿童组的体温以及血清C反应蛋白水平、白细胞计数和乳酸脱氢酶水平等数据显著高于成人组。两组的总分与上述炎症标志物或低氧血症的存在均无显著相关性。结论 本研究首次证明了MPP儿童和成人胸部X线肺部异常程度（以总分计算）与临床症状（包括低氧血症的存在）之间存在相关性。
