| 摘要: |
| ［摘要］ 目的 分析不同年龄重症及危重症肺炎支原体肺炎患儿临床特征，为临床早期识别和规范化治疗提供理论依据。方法 回顾性分析2023年10月至2024年6月中国医科大学附属盛京医院儿童重症监护病房收治的83例重症及危重症肺炎支原体肺炎患儿的临床资料，按年龄分为婴幼儿组（<3岁，23例）、学龄前组（3～6岁，17例）及学龄组（>6岁，43例）。结果 全部患儿均有咳嗽，且多以咳嗽为首发表现，79例（95.18%）伴发热。22例（26.51%）患儿病程中出现喘息，且以婴幼儿组居多，而出现呼吸困难的29例（34.94%）以学龄组居多。血液中性粒细胞/淋巴细胞及C反应蛋白明显高于正常值，而降钙素原、白介素-6升高不明显。胸部影像学以大片实变影表现居多，其次为细支气管炎表现，各年龄组胸部影像学表现存在差异。部分患儿伴有肺外并发症。21例（25.30%）患儿伴有其他病毒混合感染，病程较单一肺炎支原体感染患儿延长。有效控制病原，多数患儿常规剂量糖皮质激素即可短时间内阻止病情发展。经有效治疗，全部患儿均好转出院，随访仅少数遗留后遗症。结论 不同年龄重症及危重症肺炎支原体肺炎患儿既有相同的临床特征，又有各年龄段独特的临床表现，早期识别并采取有针对性的干预措施，可获得较好的预后。 |
| 关键词: 儿童 重症肺炎支原体肺炎 危重症肺炎支原体肺炎 临床特征 |
| DOI：10.3969/j.issn.1674-3806.2025.08.04 |
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| Analysis on clinical characteristics of severe and critical Mycoplasma pneumoniae pneumonia in children of different ages |
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REN Xue, WANG Lijie
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Department of Pediatric Emergency and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China
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| Abstract: |
| ［Abstract］ Objective To analyze the clinical characteristics of severe and critical Mycoplasma pneumoniae pneumonia in children of different ages, and to provide theoretical basis for early clinical identification and standardized treatment of the disease. Methods The clinical data of 83 pediatric patients with severe and critical Mycoplasma pneumoniae pneumonia who were admitted to the Pediatric Intensive Care Unit of Shengjing Hospital of China Medical University from October 2023 to June 2024 were retrospectively analyzed. These pediatric patients were divided into infants and young children group(<3 years, 23 patients), preschool children group(3-6 years, 17 patients) and school-age children group(>6 years, 43 patients) according to their different ages, and their clinical data were analyzed. Results All the pediatric patients had cough, and most of them presented with cough as the initial manifestation, and 79 pediatric patients(95.18%) were accompanied by fever. In the 83 pediatric patients, 22 pediatric patients(26.51%) experienced wheezing during the course of the disease. Wheezing was more common in the infants and young children group. Among the 29 pediatric patients(34.94%) who experienced dyspnea, the majority were from the school-age children group. The neutrophil to lymphocyte ratio and C-reactive protein in the blood of the pediatric patients were significantly higher than the normal values, while their procalcitonin and interleukin-6 did not increase significantly. The chest imaging manifestations of the pediatric patients were mostly characterized by diffuse consolidation shadows, followed by bronchiolitis manifestations. The chest imaging patterns varied among different age groups of the pediatric patients. Some of the pediatric patients had extrapulmonary complications. In the 83 pediatric patients, 21 pediatric patients(25.30%) were accompanied by mixed infections of other viruses. The course of the disease in the pediatric patients with mixed infections was longer than that in the pediatric patients with single Mycoplasma pneumoniae infection. With effective control of pathogens, the progression of the disease could be halted in the most pediatric patients within a short period of time after the administration of conventional doses of glucocorticoids. After effective treatments, all the pediatric patients improved and were discharged from the hospital. The follow-up results showed that only a few pediatric patients had sequelae. Conclusion Severe Mycoplasma pneumoniae pneumonia and critical Mycoplasma pneumoniae pneumonia have the same clinical characteristics in pediatric patients of different ages, but also have unique clinical manifestations in pediatric patients of various age groups. Early identification of the disease and taking targeted intervention measures can lead to a better prognosis for the pediatric patients. |
| Key words: Children Severe Mycoplasma pneumoniae pneumonia Critical Mycoplasma pneumoniae pneumonia Clinical characteristics |
