儿童难治性肺炎的早期识别与诊断
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摘要
肺炎支原体肺炎(MPP)是一种常见的儿科疾病,约占小儿社区获得性肺炎的15%～20%,在流行年可达30%。难治性肺炎支原体肺炎(RMPP)是指常规大环内酯类等药物治疗1周后无效,症状持续加重的MPP,具有病情进展快、并发症多、后遗症危害等特点。如何有效早期诊断、早期干预一直是临床研究的重点。本文就儿童难治性肺炎支原体肺炎的早期识别和诊断作一综述。
Mycoplasma pneumoniae pneumonia(MPP) is a common pediatric disease, accounting for 15% to 20% of pediatric community-acquired pneumonia and up to 30% in the epidemic year. Refractory pneumonia mycoplasma pneumonia(RMPP) refers to MPP that is ineffective after 1 week of treatment with conventional macrolides and has persistently worsening symptoms. It has the characteristics of rapid progression, complications, and sequelae. How effective early diagnosis and early intervention have always been the focus of clinical research.This article reviews the early identification and diagnosis of refractory Pneumoniae pneumonia in children.
Mycoplasma pneumoniae pneumonia(MPP) is a common pediatric disease, accounting for 15% to 20% of pediatric community-acquired pneumonia and up to 30% in the epidemic year. Refractory pneumonia mycoplasma pneumonia(RMPP) refers to MPP that is ineffective after 1 week of treatment with conventional macrolides and has persistently worsening symptoms. It has the characteristics of rapid progression, complications, and sequelae. How effective early diagnosis and early intervention have always been the focus of clinical research.This article reviews the early identification and diagnosis of refractory Pneumoniae pneumonia in children.
引文
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[3]Kawakami N,Namkoong H,Ohata T,et al.Clinical features of Mycoplasma pneumoniae pneumonia in older adults[J].Geriatrics&Gerontology International,2018,18(5):814-816.
[4]Kim JH,Kim JY,Yoo CH,et al.Macrolide Resistance and Its Impacts on M.Pneumoniae Pneumonia in Children:Comparison of Two Recent Epidemics in Korea[J].Allergy Asthma&Immunology Research,2017,9(4):340-346.
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[7]辛德莉,马红秋.难治性肺炎支原体肺炎的发病机制[J].实用儿科临床杂志,2012(4):233-234.
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[9]Kim YJ,Shin KS,Lee KH,et al.Clinical Characteristics of Macrolide-Resistant Mycoplasma pneumoniae from Children in Jeju[J].Journal of Korean Medical Science,2017,32(10):1642-1646.
[10]Tamura A,Matsubara K,Tanaka T,et al.Methylprednisolone pulse therapy for refractory Mycoplasma pneumoniae pneumonia in children[J].Journal of Infection,2008,57(3):223-228.
[11]Quan TP,Fawcett NJ,Wrightson JM,et al.Increasing burden of community-acquired pneumonia leading to hospitalisation,1998-2014[J].Thorax,2016,71(6):535-542.
[12]van Rooyen Y,Schutte AE,Huisman HW,et al.Inflammation as Possible Mediator for the Relationship Between Lung and Arterial Function[J].Lung,2016,194(1):107-115.
[13]吴幼萍,李南德,劳均华.不同剂量甲基强的松龙治疗儿童难治性肺炎支原体肺炎临床疗效及安全性分析[J].中国现代药物应用,2017,11(22):78-80.
[14]卢冠男,李大鹏,孙宏.降钙素原在呼吸系统疾病中的应用[J].吉林医药学院学报,2016,37(3):195-196.
[15]尚洁,吴晓红.C反应蛋白和降钙素原在诊断和指导难治性支原体肺炎治疗中的作用[J].河北医学,2016,22(8):1317-1318.
[16]张炎,刘国峰,周凯.小儿难治性支原体肺炎危险因素分析[J].西部医学,2015,27(4):534-535.
[17]王红连,徐进.儿童难治性肺炎支原体肺炎危险因素及支原体耐药的相关性分析[J].临床肺科杂志,2016,21(4):678-682.
[18]He J,Liu M,Ye Z,et al.Insights into the pathogenesis of Mycoplasma pneumoniae(Review)[J].Molecular Medicine Reports,2016,14(5):4030-4036.
[19]Carcey J,Garcia P,Padilla O,et al.Increased prevalence of Mycoplasma pneumoniae serological positivity in Chilean young children[J].Allergologia Et Immunopathologia,2016,44(5):467-471.
[20]Kogoj R,Praprotnik M,Mrvi? T,et al.Genetic diversity and macrolide resistance of Mycoplasma pneumoniae isolates from two consecutive epidemics in Slovenia[J].European Journal of Clinical Microbiology&Infectious Diseases,2018,37(1):1-9.
[21]Mosdósi B,Nyul Z,Nagy A,et al.Severe acrocyanosis precipitated by cold agglutinin secondary to infection with Mycoplasma pneumoniae in a pediatric patient[J].Croatian Medical Journal,2017,58(6):424-430.
[22]郭玮,何煜婷,邵琦,等.联合血降钙素原、脑钠肽、D-二聚体及PCIS评分对评估儿童重症肺炎预后的价值[J].临床儿科杂志,2017,35(8):575-579.
[23]梅淑芬,金海丽,王孙尧.儿童难治性肺炎支原体肺炎临床特点分析[J].中国中西医结合急救杂志,2017,24(2):129-132.
[24]袁天娇,刘佳禅,冯惠清.血清抗中心粒抗体检测在19例难治性肺炎支原体肺炎儿童中的应用[J].国际检验医学杂志,2017,38(10):1440.
[25]肖新广,谷梅兰,张新明,等.儿童支原体肺炎合并细菌感染的CT影像学特点分析[J].中华医院感染学杂志,2017,27(2):429-431.
[26]张义堂,杨峰,杨红.难治性肺炎患儿的CT影像学表现特点分析[J].中国CT和MRI杂志,2017,15(7):36-39.
[27]王娟,孙军,高长龙,等.纤维支气管镜肺泡灌洗术治疗儿童难治性支原体肺炎疗效分析[J].临床儿科杂志,2017,35(1):16-18.
[2]Kuwahara M,Samukawa M,Ikeda T,et al.Characterization of the neurological diseases associated with Mycoplasma pneumoniae infection and anti-glycolipid antibodies[J].Journal of Neurology,2017,264(3):467-475.
[3]Kawakami N,Namkoong H,Ohata T,et al.Clinical features of Mycoplasma pneumoniae pneumonia in older adults[J].Geriatrics&Gerontology International,2018,18(5):814-816.
[4]Kim JH,Kim JY,Yoo CH,et al.Macrolide Resistance and Its Impacts on M.Pneumoniae Pneumonia in Children:Comparison of Two Recent Epidemics in Korea[J].Allergy Asthma&Immunology Research,2017,9(4):340-346.
[5]Carrim M,Wolter N,Benitez AJ,et al.Epidemiology and Molecular Identification and Characterization of Mycoplasma pneumoniae,South Africa,2012-2015[J].Emerging Infectious Diseases,2018,24(3):506-513.
[6]曹兰芳.儿童难治性肺炎支原体肺炎的诊治现状和进展[J].临床儿科杂志,2010,28(1):94-97.
[7]辛德莉,马红秋.难治性肺炎支原体肺炎的发病机制[J].实用儿科临床杂志,2012(4):233-234.
[8]中华医学会儿科学分会呼吸学组.儿童社区获得性肺炎管理指南(2013修订)(上)[J].中华儿科杂志,2013,51(10):745-752.
[9]Kim YJ,Shin KS,Lee KH,et al.Clinical Characteristics of Macrolide-Resistant Mycoplasma pneumoniae from Children in Jeju[J].Journal of Korean Medical Science,2017,32(10):1642-1646.
[10]Tamura A,Matsubara K,Tanaka T,et al.Methylprednisolone pulse therapy for refractory Mycoplasma pneumoniae pneumonia in children[J].Journal of Infection,2008,57(3):223-228.
[11]Quan TP,Fawcett NJ,Wrightson JM,et al.Increasing burden of community-acquired pneumonia leading to hospitalisation,1998-2014[J].Thorax,2016,71(6):535-542.
[12]van Rooyen Y,Schutte AE,Huisman HW,et al.Inflammation as Possible Mediator for the Relationship Between Lung and Arterial Function[J].Lung,2016,194(1):107-115.
[13]吴幼萍,李南德,劳均华.不同剂量甲基强的松龙治疗儿童难治性肺炎支原体肺炎临床疗效及安全性分析[J].中国现代药物应用,2017,11(22):78-80.
[14]卢冠男,李大鹏,孙宏.降钙素原在呼吸系统疾病中的应用[J].吉林医药学院学报,2016,37(3):195-196.
[15]尚洁,吴晓红.C反应蛋白和降钙素原在诊断和指导难治性支原体肺炎治疗中的作用[J].河北医学,2016,22(8):1317-1318.
[16]张炎,刘国峰,周凯.小儿难治性支原体肺炎危险因素分析[J].西部医学,2015,27(4):534-535.
[17]王红连,徐进.儿童难治性肺炎支原体肺炎危险因素及支原体耐药的相关性分析[J].临床肺科杂志,2016,21(4):678-682.
[18]He J,Liu M,Ye Z,et al.Insights into the pathogenesis of Mycoplasma pneumoniae(Review)[J].Molecular Medicine Reports,2016,14(5):4030-4036.
[19]Carcey J,Garcia P,Padilla O,et al.Increased prevalence of Mycoplasma pneumoniae serological positivity in Chilean young children[J].Allergologia Et Immunopathologia,2016,44(5):467-471.
[20]Kogoj R,Praprotnik M,Mrvi? T,et al.Genetic diversity and macrolide resistance of Mycoplasma pneumoniae isolates from two consecutive epidemics in Slovenia[J].European Journal of Clinical Microbiology&Infectious Diseases,2018,37(1):1-9.
[21]Mosdósi B,Nyul Z,Nagy A,et al.Severe acrocyanosis precipitated by cold agglutinin secondary to infection with Mycoplasma pneumoniae in a pediatric patient[J].Croatian Medical Journal,2017,58(6):424-430.
[22]郭玮,何煜婷,邵琦,等.联合血降钙素原、脑钠肽、D-二聚体及PCIS评分对评估儿童重症肺炎预后的价值[J].临床儿科杂志,2017,35(8):575-579.
[23]梅淑芬,金海丽,王孙尧.儿童难治性肺炎支原体肺炎临床特点分析[J].中国中西医结合急救杂志,2017,24(2):129-132.
[24]袁天娇,刘佳禅,冯惠清.血清抗中心粒抗体检测在19例难治性肺炎支原体肺炎儿童中的应用[J].国际检验医学杂志,2017,38(10):1440.
[25]肖新广,谷梅兰,张新明,等.儿童支原体肺炎合并细菌感染的CT影像学特点分析[J].中华医院感染学杂志,2017,27(2):429-431.
[26]张义堂,杨峰,杨红.难治性肺炎患儿的CT影像学表现特点分析[J].中国CT和MRI杂志,2017,15(7):36-39.
[27]王娟,孙军,高长龙,等.纤维支气管镜肺泡灌洗术治疗儿童难治性支原体肺炎疗效分析[J].临床儿科杂志,2017,35(1):16-18.