肺炎支原体与EB病毒混合感染后肺炎的临床及实验室特征

摘要

目的：探讨肺炎支原体(MP)合并EB病毒(EBV)混合感染后肺炎的临床及实验室特征。方法选取2013年5月—2014年4月期间因肺炎住院治疗且病原学检测MP及EBV均阳性的122例患儿作为混合感染组，并将同期入院的45例单纯MP肺炎患儿作为对照组。收集所有患儿的临床和实验室检查资料进行分析。结果 MP及EBV混合感染检出率为5.51%(122/2213)。随着年龄增大，混合感染检出率逐渐升高(χ2=84.08，P<0.001)。大叶性肺炎患儿混合感染检出率明显高于支气管肺炎患儿(χ2=37.44，P<0.001)。MP合并高考贝数EBV感染组(高混组)、低混组与对照组三组间比较，高混组ALT及CK-MB升高，大叶性实变发生率高，发热时间及住院时间较长(P均<0.05)。高混组ALT、CK-MB升高发生率，发热时间及住院时间高于低混组(P均<0.05)。结论 MP及EBV混合感染可加重肺内外损伤，EBV拷贝数高低是影响MP混合EBV感染后肺炎肺内外损伤程度的重要原因。当MPP患儿临床症状较重、肺外损伤明显时，必要的EBV检测，特别是定量检测可有利于临床正确的诊断及合适的治疗。%ObjectiveTo study the clinical characteristics and laboratory ifndings ofMycoplasma pneumoniae (MP) and EBV infection in children and provide reference for clinical diagnosis and treatment.MethodsOne hundred and twenty two (122) hospitalized children with pathogen detection of MP and EBV double positive in hospitalized children with pneumonia from May 2013 to April 2014 (n=2213) were recruited as mixed infection group. In the mixed infection group, patients were further devided into high EBV mixed infection group if the EBV DNA copies were more than 1.0×104 copies/ml and the low EBV mixed infec-tion group when EBV DNA copies were less than 1.0×104 copies/ml. And another 45 hospitalized children with MP pneumonia were rectuited as control group. Clinical data and laboratory ifndings of all children were collected and analyzed.Results The mixed infection rate of MP and EBV was 5.51% (122/2213). As children getting older, the incidence of mixed infection was increased (χ2=84.08,P<0.001). And the mixed infection incidence in the lobar pneumonia group was signiifcantly higher than the bronchopneumonia group (χ2=37.44,P<0.001). The incidence of ALT and CK-MB elevated, lobar pneumonia, average fever days and hospitalization days in mixed infection with the high EBV copies group were signiifcantly higher than those in the low EBV copies group and the control group (bothP<0.05). The incidence of ALT and CK-MB elevated, average fever days and hos-pitalization days in mixed infection with the high EBV copies group were signiifcantly higher than those of the low EBV copies group and the control group (allP<0.05).ConclusionThe mixed infection of MP and EBV could aggravate the injury both in and out of the lung. Number of EBV copies plays an important role in the degree of injury both inside and outside the lung due to pneumonia with mixed infection of MP and EBV. When a patient with MP pneumonia complains with severe clinical symptoms and obvious injury outside the lung, EBV detection, especially quantitative detection of EBV DNA copies could be beneifcial for clinical diagnosis and treatment.