不同年龄肺炎支原体肺炎患儿胸片与实验室检查特点比较

摘要

Objective To explore the difference of complete blood count, C-reactive protein ( CRP) and humeral immunity in children of different ages with Mycoplasma pneumonia pneumonia (MPP) manifested as lobar pneumonia and bronchopneumonia. Methods Two hundred and eleven children with MPP were enrolled and divided by ages, one month to six years and older than six years, and by chest radiographic manifested, lobar pneumonia group and bronchopneumonia group. Complete blood count, CRP and humeral immunity were detected at admission. Results The rate of lobar pneumonia in older than six years group is 45.92%, which was significantly higher than one month to six years group (X2 = 13.4, P < 0.001) . In one month to 6 years group, the lymphocyte count was significantly lower in lobar pneumonia group than in bronchial pneumonia group (P < 0.05). In older than six years group, the levels of IgA and IgM were significantly lower in lobar pneumonia than in bronchial pneumonia group (P < 0.05). In two age groups, the level serum CRP was significantly higher in lobar pneumonia group than in bronchial pneumonia group (P < 0.05). Conclusions Lobar pneumonia is more common in older children with MPP. It may be one of manifestations of intensive systemic inflammatory response to Mycoplasma pneumonia infection. Lymphopenia and early specific antibody insufficiency at early stage may also be related to the occurrence of lobar pneumonia.%目的 探讨不同年龄肺炎支原体肺炎(MPP)患儿表现为大叶性肺炎和支气管肺炎时,血常规、血清C反应蛋白(CRP)及体液免疫各项指标的变化.方法 MPP患儿211例,根据年龄分为1个月～6岁组和≥6岁组,同时依据胸片表现分为大叶性肺炎组和支气管肺炎组.入院初检测血常规、CRP及体液免疫指标.结果 ≥6岁组患儿MPP大叶性肺炎发生率为45.92％,高于1个月～6岁组的22.12％(x2=13.4,P＜ 0.001).在1个月～6岁组中,大叶性肺炎患儿外周血淋巴细胞比例低于支气管肺炎患儿(P＜0.05)；而在≥6岁组患儿中,两者差异无统计学意义(P＞0.05).≥6岁组大叶性肺炎患儿的血清IgA、IgM含量低于支气管肺炎患儿(P＜0.05).两个年龄组大叶性肺炎患儿的血清CRP含量均高于支气管肺炎患儿(P＜0.05). 结论 年长儿MPP以大叶性肺炎多见,可能是年长儿MP感染后机体全身炎症反应强烈的表现之一,MP感染后淋巴细胞减少和早期特异性抗体产生不足也可能与大叶性肺炎的发生有关.