哮喘患儿肺炎支原体和衣原体感染状况调查
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摘要
目的探讨哮喘患儿肺炎支原体和衣原体感染的相关性及临床特点。方法选择2014年1月-2016年1月医院收治的哮喘患儿1286例,支原体和(或)衣原体感染哮喘患儿824例设为试验组,并与非肺炎支原体或(和)衣原体感染患儿462例设为对照组,比较两组患儿的临床资料,总结哮喘患儿肺炎支原体和衣原体感染的临床特点。结果 1286例哮喘患儿中,出现肺炎支原体或(和)衣原体感染824例,感染率为64.07%,其中单纯肺炎支原体感染583例,单纯肺炎衣原体感染201例,40例患儿同时感染肺炎支原体和衣原体;试验组患儿年龄段<1岁多于对照组,对照组实验室指标嗜酸性粒细胞计数与C-反应蛋白分别为(284.24±48.33)×106/L与(6.84±0.73)mg/L低于试验组(396.34±64.63)×106/L、(7.94±0.83)mg/L;白细胞计数和前降钙素原(PCT)分别为(7.84±0.83)×109/L和(0.72±0.07)μg/L高于研究组(P<0.05),两组胸片胸腔积液、云雾状改变、肺间质浸润、肺间质和肺实质混合浸润、扇形浸润、肺实质浸润,差异均有统计学意义(P<0.05);试验组患儿临床表现发热96.84%、头痛60.92%、咳嗽71.48%、胸痛30.70%高于对照组(P<0.05);肺炎支原体感染哮喘患儿流鼻涕22.13%、喘鸣13.38%高于衣原体感染患儿12.44%、6.97%,腹泻8.92%、呕吐8.40%均低于衣原体感染患儿17.41%、14.43%(P<0.05)。结论哮喘患儿并发肺炎支原体和(或)衣原体感染率较高,且具有一定的临床特征,可为临床诊断和治疗提供一定的参考,提高患儿经验性用药选择准确性。
OBJECTIVE To investigate the correlation and clinical characteristics of Mycoplasma pneumoniae and Chlamydia pneumoniae infections in children with asthma.METHODS A total of 1286 cases of children with asthma from Jan.2014 to Jan.2016 y admitted to the hospital were selected.Totally 824 cases of Children with Mycoplasma pneumoniae and(or)C.pneumoniae infections with asthma were set as observation group,and non M.pneumoniae and(or)C.pneumoniae infections were set as control group.The clinical data of the two groups were compared,and the clinical characteristics of M.pneumoniae and C.pneumoniae infection in children with asthma were summed up.RESULTS Among 1286 cases of children with asthma,there were 824 cases of M.pneumoniae and(or)C.pneumoniainfections,and the infection rate was 64.07%,of which 583 cases were M.pneumoniae infection,201 cases of C.pneumoniae infections,and 40 cases were Mycoplasma pneumoniae and Chlamydia pneumoniae infection.The observation group with age less than 1 year old was more than that of control group,the laboratory index of eosinophil count and C-reactive protein of control group were(284.24±48.33)×106/L and(6.84±0.73)mg/L,which were lower than(396.34±64.63)×106/L and(7.94±0.83)mg/L of observation group,white blood cell count and procalcitonin(PCT)of observation group were(7.84±0.83)×109/L and(0.72±0.07)μg/L,which were significantly higher than observation group(P<0.05),and the chest pleural effusion,cloud like changes,interstitial lung infiltration,interstitial lung and lung parenchyma infiltration,fan-shaped infiltration and lung parenchyma infiltration between the two groups had significant differences(P<0.05).The clinical manifestations of fever(96.84%),headache(60.92%),cough(71.48%),and chest pain(30.70%)of observation group were significantly higher than control group(P<0.05).Runny nose(22.13%)and wheezing rate(13.38%)in asthma children with mycoplasma pneumonia were significantly higher than 12.44% and 6.97% of Chlamydia infectionin children,and diarrhea(8.92%)and vomiting(8.40%)were significantly lower than 17.41% and14.43% of Chlamydiainfection in children(P<0.05).CONCLUSIONThe infection rate of children with asthma and M.pneumoniae and(or)C.pneumoniae infections is higher,and has certain clinical features,which can provide a reference for the diagnosis and treatment of children with asthma and improve the accuracy of children's experimental drug selection.
OBJECTIVE To investigate the correlation and clinical characteristics of Mycoplasma pneumoniae and Chlamydia pneumoniae infections in children with asthma.METHODS A total of 1286 cases of children with asthma from Jan.2014 to Jan.2016 y admitted to the hospital were selected.Totally 824 cases of Children with Mycoplasma pneumoniae and(or)C.pneumoniae infections with asthma were set as observation group,and non M.pneumoniae and(or)C.pneumoniae infections were set as control group.The clinical data of the two groups were compared,and the clinical characteristics of M.pneumoniae and C.pneumoniae infection in children with asthma were summed up.RESULTS Among 1286 cases of children with asthma,there were 824 cases of M.pneumoniae and(or)C.pneumoniainfections,and the infection rate was 64.07%,of which 583 cases were M.pneumoniae infection,201 cases of C.pneumoniae infections,and 40 cases were Mycoplasma pneumoniae and Chlamydia pneumoniae infection.The observation group with age less than 1 year old was more than that of control group,the laboratory index of eosinophil count and C-reactive protein of control group were(284.24±48.33)×106/L and(6.84±0.73)mg/L,which were lower than(396.34±64.63)×106/L and(7.94±0.83)mg/L of observation group,white blood cell count and procalcitonin(PCT)of observation group were(7.84±0.83)×109/L and(0.72±0.07)μg/L,which were significantly higher than observation group(P<0.05),and the chest pleural effusion,cloud like changes,interstitial lung infiltration,interstitial lung and lung parenchyma infiltration,fan-shaped infiltration and lung parenchyma infiltration between the two groups had significant differences(P<0.05).The clinical manifestations of fever(96.84%),headache(60.92%),cough(71.48%),and chest pain(30.70%)of observation group were significantly higher than control group(P<0.05).Runny nose(22.13%)and wheezing rate(13.38%)in asthma children with mycoplasma pneumonia were significantly higher than 12.44% and 6.97% of Chlamydia infectionin children,and diarrhea(8.92%)and vomiting(8.40%)were significantly lower than 17.41% and14.43% of Chlamydiainfection in children(P<0.05).CONCLUSIONThe infection rate of children with asthma and M.pneumoniae and(or)C.pneumoniae infections is higher,and has certain clinical features,which can provide a reference for the diagnosis and treatment of children with asthma and improve the accuracy of children's experimental drug selection.
引文
[1]李晶,戴蔷蕾.小儿支气管哮喘急性发作与肺炎支原体感染的相关性研究[J].中华医院感染学杂志,2013,23(12):2923-2925.
[2]Pandak N,Pajic-PenavicI,Zidovec-Lepej S,et al.Chlamydophila pneumoniae and Mycoplasma pneumoniae were not identified in sinus mucosa of patients with chronic rhinosinusitis[J].Eur Arch Otorhinolaryngol,2014,271(6):1553-1555.
[3]Bébéar C,Raherison C,Nacka F,et al.Comparison of Mycoplasma pneumoniae infections in asthmatic children versus asthmatic adults[J].Pediatr Infect Dis J,2014,33(3):e71-e75.
[4]中华医学会儿科学分会呼吸学组《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南[J].中华儿科杂志,2008,46(10):745-753.
[5]MSharavin AO,Smirnova SV.Mycoplasma and Chlamydia as ethiological factors of bronchial asthma in terms of ethnogenesis[J].Vestn Ross Akad Med Nauk,2013,(7):57-60.
[6]Qasem JA,Al-Khalaf BN,Qasem AA,et al.Application of three uniplex polymerase-chain-reaction assays for the detection of atypical bacteria in asthmatic patients in Kuwait[J].J Infect Public Health,2013,6(2):134-141.
[7]王爱虹,王景刚,宋永辉,等.哮喘患儿肺炎衣原体及肺炎支原体感染的临床特征分析[J].中华医院感染学杂志,2015,25(2):446-448.
[8]Metz G,Kraft M.Effects of atypical infections with Mycoplasma and Chlamydia on asthma[J].Immunol Allergy Clin North Am,2010,30(4):575-585.
[9]易绘,吴方辉.MP、CP与哮喘预测指数阳性小儿发病相关性研究[J].国际医药卫生导报,2013,19(2):162-164.
[10]Parrott GL,Kinjo T,Fujita J.A Compendium for Mycoplasma pneumoniae[J].Front Microbiol,2016(7):513.
[11]Wang RS,Jin HX,Shang SQ,et al.Associations of IL-2and IL-4expression and polymorphisms with the risks of Mycoplasma pneumoniae infection and asthma in children[J].Arch Bronconeumol,2015,51(11):571-578.
[12]朱道娟,彭东红,黄英,等.2013年某院儿童哮喘急性发作住院患儿的病原特点分析[J].重庆医学,2015,44(19):2629-2631.
[13]Zhang H,Lv G,Shang Y,et al.Changes of airway reactivity after Mycoplasma pneumoniae infection in children:a study for early precautions against pediatric asthma[J].Iran J Allergy Asthma Immunol,2015,14(5):476-482.
[14]左艳芳,张丽,张静,等.毛细支气管炎与哮喘的关系研究进展[J].中国综合临床,2014,30(6):669-672.
[15]Duenas Meza E,Jaramillo CA,Correa E,et al.Virus and Mycoplasma pneumoniae prevalence in a selected pediatric population with acute asthma exacerbation[J].J Asthma,2016,53(3):253-260.
[2]Pandak N,Pajic-PenavicI,Zidovec-Lepej S,et al.Chlamydophila pneumoniae and Mycoplasma pneumoniae were not identified in sinus mucosa of patients with chronic rhinosinusitis[J].Eur Arch Otorhinolaryngol,2014,271(6):1553-1555.
[3]Bébéar C,Raherison C,Nacka F,et al.Comparison of Mycoplasma pneumoniae infections in asthmatic children versus asthmatic adults[J].Pediatr Infect Dis J,2014,33(3):e71-e75.
[4]中华医学会儿科学分会呼吸学组《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南[J].中华儿科杂志,2008,46(10):745-753.
[5]MSharavin AO,Smirnova SV.Mycoplasma and Chlamydia as ethiological factors of bronchial asthma in terms of ethnogenesis[J].Vestn Ross Akad Med Nauk,2013,(7):57-60.
[6]Qasem JA,Al-Khalaf BN,Qasem AA,et al.Application of three uniplex polymerase-chain-reaction assays for the detection of atypical bacteria in asthmatic patients in Kuwait[J].J Infect Public Health,2013,6(2):134-141.
[7]王爱虹,王景刚,宋永辉,等.哮喘患儿肺炎衣原体及肺炎支原体感染的临床特征分析[J].中华医院感染学杂志,2015,25(2):446-448.
[8]Metz G,Kraft M.Effects of atypical infections with Mycoplasma and Chlamydia on asthma[J].Immunol Allergy Clin North Am,2010,30(4):575-585.
[9]易绘,吴方辉.MP、CP与哮喘预测指数阳性小儿发病相关性研究[J].国际医药卫生导报,2013,19(2):162-164.
[10]Parrott GL,Kinjo T,Fujita J.A Compendium for Mycoplasma pneumoniae[J].Front Microbiol,2016(7):513.
[11]Wang RS,Jin HX,Shang SQ,et al.Associations of IL-2and IL-4expression and polymorphisms with the risks of Mycoplasma pneumoniae infection and asthma in children[J].Arch Bronconeumol,2015,51(11):571-578.
[12]朱道娟,彭东红,黄英,等.2013年某院儿童哮喘急性发作住院患儿的病原特点分析[J].重庆医学,2015,44(19):2629-2631.
[13]Zhang H,Lv G,Shang Y,et al.Changes of airway reactivity after Mycoplasma pneumoniae infection in children:a study for early precautions against pediatric asthma[J].Iran J Allergy Asthma Immunol,2015,14(5):476-482.
[14]左艳芳,张丽,张静,等.毛细支气管炎与哮喘的关系研究进展[J].中国综合临床,2014,30(6):669-672.
[15]Duenas Meza E,Jaramillo CA,Correa E,et al.Virus and Mycoplasma pneumoniae prevalence in a selected pediatric population with acute asthma exacerbation[J].J Asthma,2016,53(3):253-260.