| 摘要: |
| 目的:探讨儿童肺炎支原体细支气管炎的临床特点,提高临床对该病的诊治水平。方法:选择2022 年6 月至2023 年
7 月我院儿科病房诊治的189 例肺炎支原体细支气管炎患儿为研究对象;根据年龄分为3 组:婴幼儿组( ≤3 岁)、学龄前儿
童组( >3~6 岁)及学龄期儿童组( >6~13 岁)。回顾性分析3 组患儿的临床特点、实验室指标、胸部影像学、治疗和转归情
况。结果:189 例肺炎支原体细支气管炎患儿,中位年龄7 岁。临床表现上,所有患儿均有咳嗽,178 例(94. 18%) 发热,发热持
续时间7(5,8) d,住院时间8(7,9) d。不同年龄组中性粒细胞与淋巴细胞比值、全身免疫炎症指数、超敏C 反应蛋白有明显差
异,白蛋白、天冬氨酸氨基转移酶升高、血清球蛋白降低在婴幼儿组中更常见,凝血酶原时间、国际标准化比值、纤维蛋白原3 组
间比较差异有统计学意义。胸部高分辨CT 检查主要表现为弥漫性小结节影177 例(93. 65%)。所有患儿予大环内酯类或四环
素类药物治疗,使用甲泼尼龙的患儿128 例(67. 72%),平均激素使用时间3(0,5) d。结论:肺炎支原体细支气管炎患儿均有咳
嗽,大部分伴发热,部分患儿病程中可有喘息、气促,胸部高分辨CT 主要表现为弥漫性病变。经积极治疗,多数患儿预后良好。 |
| 关键词: 肺炎支原体 细支气管炎 闭塞性细支气管炎 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2026.05.001 |
|
| 基金项目:基金项目:国家自然科学基金,编号82400025;常州市科学技术局项目,编号CJ20230067、CJ20245023;常州市卫健委科技项目,编号
QN202316。 |
|
| Clinical Characteristics Analysis of Mycoplasma Pneumoniae Bronchiolitis in Children and Early DrugStratified Intervention Strategy: Based on 189 Cases |
| Jiang Fei, Wan Yu, Zhang Liwen, Yang Qianyuan, Fan Fei, Huang Zhiying |
| (The Third Affiliated Hospital of Nanjing
Medical University, the Second People’s Hospital of Changzhou, Jiangsu Changzhou 213000, China) |
| Abstract: |
| Objective: To probe into the clinical characteristics of Mycoplasma pneumoniae bronchiolitis in children, and to improve
the diagnosis and treatment of the disease in the clinic. Methods: A total of 189 children diagnosed with M. pneumoniae bronchiolitis
in the pediatric ward of our hospital from Jun. 2022 to Jul. 2023 were extracted to be stratified into three age-based groups: infant
group (⩽ 3 years), preschool children group (> 3 to 6 years), school-age children group (> 6 to 13 years). Clinical characteristics,
laboratory indicators, chest imaging findings, treatment, and outcomes were retrospectively analyzed. Results: The median onset age of
the 189 children with M. pneumoniae bronchiolitis was 7 years. The clinical manifestations were cough in all children, fever in 178 cases
(94. 18%), the fever duration was 7(5, 8) d, and length of hospital stay was 8(7, 9) d. Significant differences were found across
different age groups in neutrophil-to-lymphocyte ratio, systemic inflammatory index, and high-sensitivity C-reactive protein. Albumin and
aspartate aminotransferase elevation and serum globulin reduction were more common in the infant group. Prothrombin time,
international normalized ratio, and fibrinogen varied significantly among the three groups. Chest high-resolution CT revealed diffuse
micronodules in 177 cases (93. 65%). All patients were treated with macrolides or tetracyclines, and 128 cases (67. 72%) received
methylprednisolone, with a mean duration of hormone therapy of 3 (0, 5) d. Conclusion: Children with M. pneumoniae bronchiolitis
uniformly have cough, most with fever, some children may have wheezing and shortness of breath in the course of disease. With prompt
therapeutic intervention, most of the children have a good prognosis. |
| Key words: Mycoplasma pneumoniae bronchiolitis bronchiolitis obliterans |
