| 引用本文: | 马文静,曹兰芳.肺炎支原体诱发的儿童关节炎30例临床分析[J].中国临床新医学,0,():-. |
| 马文静,Cao Lanfang.肺炎支原体诱发的儿童关节炎30例临床分析[J].中国临床新医学,0,():-. |
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| 肺炎支原体诱发的儿童关节炎30例临床分析 |
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马文静, 曹兰芳
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作者单位：上海交通大学医学院附属仁济医院嘉定分院儿科
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| 摘要: |
| 目的 分析肺炎支原体(MP)诱发的儿童关节炎的临床特征,以提高对该病诊疗的认识。方法 收集2024年1月1日至2025年6月30日我院儿科收治的30例MP诱发的关节炎患儿临床病例资料。回顾性分析患儿的临床特征、影像学改变,治疗及疗效。结果 1.30例患儿中男11例,女19例,男女比例约为1:2。年龄1.5~13岁,平均年龄8.2±2.41岁,发病年龄集中在学龄期。2.首发症状以关节疼痛(100%,30例)为主,以下肢关节中的膝关节(80%,24例)、髋关节(40%,12例)、踝关节(36.7%,11例)受累多见,且呈非对称性。3.受累关节肌骨超声以关节腔积液(43处,59.7%)和滑膜炎(33处,45.8%)为主要表现,核磁共振以关节腔积液(33处,56.9%)为主要表现,未发现明显骨质破坏。4.30例患儿治疗前JADAS27评分为7.95(IQR：7.4)分,处于疾病活动状态。治疗上予以清除病原体及保护血管,部分联合糖皮质激素。治疗后JADAS27评分为1.05(IQR：3.74)分,与治疗前相比明显改善,差异有统计学意义(P<0.001)。20例患儿关节症状在随访6个月后基本恢复正常,未观察到明显并发症。结论 肺炎支原体诱发的儿童关节炎发病年龄集中在学龄期女童,典型症状为下肢大关节非对称性疼痛,影像学检查以关节积液及滑膜炎为主要表现。早期识别并采取有针对性的干预措施,可改善预后。 |
| 关键词: 肺炎支原体 儿童关节炎 临床特征 影像学表现 |
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| Analysis of clinical characteristics of 30 Cases of Mycoplasma pneumoniae-Induced Arthritis in ChildrenMA Wenjing, CAO Lanfang. Department of Pediatrics, Jiading Branch, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201800, China |
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马文静, Cao Lanfang
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Jiading Branch,Ren Ji Hospital,Shanghai Jiao Tong University School of Medicine
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| Abstract: |
| ObjectiveSTo analyze the clinical characteristics of Mycoplasma pneumoniae-induced arthritis in children, and to provide theoretical basis for early clinical identification and standardized treatment of the disease. MethodsSThe clinical data of 30 pediatric patients withSMycoplasma pneumoniae-induced arthritis who were admitted to the Department of Pediatrics of Jiading Branch, Ren Ji Hospital of Shanghai Jiao Tong University School of Medicine from January 1, 2024 and June 30, 2025. A retrospective analysis was conducted to assess the clinical characteristics, imaging changes, managements, and treatment outcomes. ResultsS1.Among the 30 patients, 11 are males and 19 are females, with a ratio of about 1:2. The age range was 1.5 to 13 years, with a mean age of 8.2±2.41 years; The onset age was mainly concentrated in the school-age. 2. The initial symptoms were mainly joint pain(100%, 30cases). Asymmetric involvement chiefly affected the lower limbs, particularly the knees (80%, 24 cases), hips (40%, 12 cases), and ankles (36.7%, 11 cases). 3. The MSUS findings of affected joints mainly included joint cavity effusion(43 joints,59.7%) and synovitis(33 joints,45.8%). The MRI findings of affected joints mainly included joint cavity effusion(33 joints,56.9%). No significant bone destruction was detected. 4. At baseline, the mean JADAS27 score was 7.95(IQR：7.4), reflecting disease activity level. Management strategies comprised antimicrobial therapy targeting pathogen clearance and vascular protection, with adjunct glucocorticoids administered in select cases. This intervention led to a statistically significant reduction in the JADAS27 score to 1.05(IQR：3.74)post-treatment. Moreover, 20 children exhibited essentially complete resolution of joint symptoms at the 6-month follow-up, and no notable complications were recorded. ConclusionSThe onset age of Mycoplasma pneumoniae-induced arthritis is concentrated in school age, with more females than males. It is characterized by asymmetric pain in the large joints of the lower limbs, with imaging studies primarily revealing joint effusion and synovitis. Early recognition and targeted intervention are crucial for improving prognosis. |
| Key words: S Mycoplasma pneumoniae arthritis Clinical characteristics Imaging findings |
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