难治性肺炎支原体肺炎的发病机制

摘要

大多数肺炎支原体肺炎（MPP）经大环内酯类抗生素治疗后病情控制，但近年发现难治性肺炎支原体肺炎（RMPP）较前增多（其中一部分为重症肺炎支原体肺炎，SMPP），常导致严重肺内外并发症，如坏死性肺炎等，并且易遗留闭塞性细/支气管炎、肺不张以及支气管扩张等后遗症。目前认为MPP是由于肺炎支原体（MP）直接侵犯肺部和支气管组织以及MP激发机体的过度炎症反应两个主要原因造成，而RMPP尚与MP载量、MP耐药、气道黏液高分泌、高凝状态、混合细菌或病毒感染和社区获得性呼吸窘迫综合征毒素产生有关。探索RMPP的发病机制，以探索有效干预方法，阻止后遗症的发生。%Most of Mycoplasma pneumoniae pneumonia (MPP) will be controlled after being treated with macrolide antibiotics. But in recent years refractory Mycoplasma pneumoniae pneumonia (RMPP), including severe mycoplasma pneumoniae pneumonia, are increased. RMPP often causes many severe complications and sequelae such as necrotizing pneumonia, bronchiolitis obliterans, bronchitis obliterans, atelectasis and bronchiectasis. Two main mechanisms of MPP are proposed: damages to airway directly by mycoplasma pneumonia (MP), and inflammatory reaction caused by mycoplasma pneumoniae (MP). RMPP is also associated with many other factors such as MP genotype and load, macrolide-resistant MP, airway mucus hypersecretion, hypercoagulability, combined infection with bacteria or viruses, and community acquired respiratory distress syndrome toxin (CARDS Tx). The exploration of mechanisms of RMPP helps us acquire effective treatment and prevent sequelae.