| 摘要: |
| ［摘要］ 目的 分析肺炎支原体（MP）感染相关的幼年关节炎的临床特征，以提高临床医师对该病诊疗的认识。方法 回顾性分析2024年1月1日至2025年6月30日上海交通大学医学院附属仁济医院嘉定分院儿科收治的30例MP感染相关的幼年关节炎的临床资料，对患儿的临床特征、影像学检查结果、治疗及预后情况进行总结。结果 30例患儿中男11例，女19例。发病年龄1岁6个月至13岁，平均发病年龄（8.2±2.4）岁，发病年龄集中在学龄期（6～<10岁）。首发临床症状均为关节疼痛，受累关节数≥2个者占86.7%，以下肢关节中的膝关节（80.0%）、髋关节（40.0%）、踝关节（36.7%）多见，且呈非对称性分布。23例患儿接受关节肌骨超声（MSUS）检查，异常表现主要为关节腔积液和滑膜炎。22例患儿接受关节磁共振成像（MRI）检查，异常表现主要为关节腔积液，未发现明显骨质破坏。30例患儿治疗前幼年关节炎疾病活动性量表27（JADAS27）评分为9.1（5.4，12.1）分，处于疾病活动期，予针对MP感染的标准抗生素治疗及对症治疗后（或联合糖皮质激素治疗），其JADAS27评分下降至1.2（0.0，2.4）分，差异有统计学意义（Z=4.983，P<0.01）。20例患儿关节损害症状在6个月内完全恢复，其余10例患儿仍在随访中，临床症状明显缓解。30例患儿总体预后良好，未出现其他系统并发症。结论 MP感染相关的幼年关节炎多发于学龄期儿童，典型症状为下肢大关节非对称性疼痛，影像学检查以关节腔积液和滑膜炎为主要异常表现。早期识别并采取有针对性的干预措施，患儿可获得较好预后。 |
| 关键词: 肺炎支原体 幼年关节炎 临床特征 影像学表现 |
| DOI：10.3969/j.issn.1674-3806.2026.05.14 |
| 分类号:R 729 |
| 基金项目: |
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| Analysis on clinical characteristics of 30 cases of Mycoplasma pneumoniae infection-associated juvenile arthritis |
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MA Wenjing, CAO Lanfang
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Department of Pediatrics, Jiading Branch, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201800, China
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| Abstract: |
| ［Abstract］ Objective To analyze the clinical characteristics of Mycoplasma pneumoniae(MP) infection-associated juvenile arthritis and to enhance clinicians′ understanding of the diagnosis and treatment of the disease. Methods A retrospective analysis was conducted on the clinical data of 30 pediatric patients with MP infection-associated juvenile arthritis who were admitted to Department of Pediatrics, Jiading Branch, Renji Hospital, Shanghai Jiao Tong University School of Medicine from January 1, 2024 to June 30, 2025. The clinical characteristics, imaging examination results, treatment and prognosis of the patients were summarized. Results Among the 30 pediatric patients, 11 patients were male and 19 patients were female. The onset age ranged from 1 year and 6 months to 13 years, with an average onset age of (8.2±2.4)years, and was predominantly in school ages(6～<10 years). The initial clinical symptoms of all the patients were manifested as joint pain. The number of affected joints was mostly more than two(86.7%), and the knee joints(80.0%), hip joints(40.0%), and ankle joints(36.7%) in the lower extremity joints were more common, and they distributed asymmetrically. Twenty-three patients underwent musculoskeletal ultrasound(MSUS) examination on the joints. Their abnormal manifestations were mainly joint cavity effusion and synovitis. Twenty-two patients underwent magnetic resonance imaging(MRI) examination on the joints. The main abnormal finding was joint cavity effusion, with no significant bone destruction observed. Before treatment, the 27-Joint Juvenile Arthritis Disease Activity Scores(JADAS27) of the 30 patients were 9.1(5.4, 12.1)points, indicating that they were in the active stage of the disease. After the standard antibiotic treatment and symptomatic treatment for MP infection(or combined with glucocorticoid treatment), their JADAS27 dropped to 1.2(0.0, 2.4)points, and the difference was statistically significant(Z=4.983, P<0.01). The symptoms of joint damage in 20 patients were completely recovered within 6 months, while the other 10 patients were still under follow-up, and their clinical symptoms were significantly relieved. On the whole, the prognosis of the 30 patients was good, and no complications in other systems were observed. Conclusion MP infection-associated juvenile arthritis is more common in school age children. The typical symptoms are asymmetric pain in the large joints of the lower extremities. The imaging findings are joint effusion and synovitis as the main abnormal manifestations. Early identification and targeted intervention measures can lead to favorable prognosis for the pediatric patients. |
| Key words: Mycoplasma pneumoniae(MP) Juvenile arthritis Clinical characteristics Imaging manifestations |
