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目的探讨儿童肺炎支原体肺炎的临床特点以及肺外并发症的表现,为肺炎支原体肺炎患儿的临床诊断及治疗提供依据。方法选取2010年1月—2013年1月收治的肺炎支原体肺炎患儿200例为观察组,选取同期收治的上呼吸道感染患儿100例为对照1组,选取100例健康儿童为对照2组。同时空腹抽取各组受试者静脉血3ml,采用ELISA酶联免疫法测定各组血清中IL-6、IL-17、TNF-α水平。观察组进行药敏试验。计量资料采用F检验,P<0.05为差异有统计学意义。结果 3~6岁发病最多,占44.00%,中度咳嗽占61.00%。患儿平均体温为(39.4±3.4)℃,发热时间平均(8.3±1.6)d。X线摄片可发现左侧肺部出现阴影者42.00%,右侧肺部出现阴影者31.00%,双侧肺部出现阴影者27.00%。观察组患儿血清中IL-6、IL-17、TNF-α水平[(81.21±16.35)、(28.21±7.24)、(32.96±1.74)μmol/L]显著高于对照1组[(52.62±12.87)、(8.23±2.69)、(10.35±3.65)μmol/L]及对照2组[(33.26±14.21)、(6.58±1.63)、(2.32±1.42)μmol/L],两两对比差异均有统计学意义(均P<0.05)。观察组共分离出肺炎支原体致病菌270株,肺炎支原体对阿奇霉素较敏感,而对卡那霉素、链霉素、丁胺卡那、四环素、新霉素、复方磺胺、青霉素G、氨苄霉素耐药性较高。结论肺炎支原体肺炎患儿临床表现为多系统性器官损害。IL-6、IL-17、TNF-α等炎症因子水平的上升可能是导致肺炎支原体肺炎发生的重要因素,通过测定患儿炎症因子水平能有效对患儿病情做出诊断。
Objective To investigate the clinical features of children with Mycoplasma pneumoniae pneumonia and the manifestations of extrapulmonary complications and provide evidence for the clinical diagnosis and treatment of children with Mycoplasma pneumoniae pneumonia. Methods 200 children with mycoplasma pneumoniae pneumonia admitted from January 2010 to January 2013 were selected as observation group. 100 children with upper respiratory tract infection were selected as control group 1 and 100 healthy children as control group. At the same time, 3 ml venous blood of each group was drawn on fasting, and the levels of IL-6, IL-17 and TNF-α in serum of each group were measured by enzyme-linked immunosorbent assay. Observation group for susceptibility testing. Measurement data using F test, P <0.05 for the difference was statistically significant. Results 3 to 6 years old the most incidence, accounting for 44.00%, moderate cough accounted for 61.00%. The average body temperature of children was (39.4 ± 3.4) ℃, the average fever time (8.3 ± 1.6) d. X-ray findings revealed that 42.00% of the left lung shadow, 31.00% of the right lung shadow, 27.00% of the bilateral lung shadow. The serum levels of IL-6, IL-17 and TNF-α in the observation group were significantly higher than those in the control group [(52.22 ± ± 2.81) ± (81.21 ± 16.35), (28.21 ± 7.24), (32.96 ± 1.74) μmol / 12.87), (8.23 ± 2.69) and (10.35 ± 3.65) μmol / L, respectively, compared with the control group 2 (33.26 ± 14.21, 6.58 ± 1.63 and 2.32 ± 1.42 μmol / L, respectively) There was statistical significance (all P <0.05). In the observation group, 270 Mycoplasma pneumoniae pathogens were isolated. Mycoplasma pneumoniae was more sensitive to azithromycin, while kanamycin, streptomycin, amikacin, tetracycline, neomycin, sulfamethoxazole, penicillin G, Supresistance is higher. Conclusion The clinical manifestations of mycoplasma pneumonia in children with multiple systemic organ damage. Elevated levels of IL-6, IL-17, TNF-α and other inflammatory factors may be an important factor in the pathogenesis of Mycoplasma pneumoniae pneumonia. By measuring the level of inflammatory cytokines in children, the diagnosis of children’s condition can be effectively made.