头痛为惟一症状的肺炎支原体感染病例分析

摘要

目的：探讨分析头痛为惟一症状的肺炎支原体感染的诊断与治疗。方法回顾性分析2012年3月至2015年2月就诊于本院儿科门诊头痛患者（肺炎支原体抗体阳性）10例。头痛为惟一症状，无阳性体征；检查肺炎支原体抗体、血常规、血生化等，对白细胞、中性粒细胞绝对值及血小板计数进行治疗前后自身对比；并进行视频脑电图、颅脑磁共振成像及经颅多普勒等检查。结果10例以头痛为惟一症状的患者，疼痛特点是反复发作，头额、双顶、颞部为主，轻中度钝痛为主，可忍受，用力或活动加重；肺炎支原体抗体均在1：80以上，白细胞计数治疗前为（6.81±1.49）×109/L、治疗后为（6.96±1.09）×109/L，治疗前与治疗后相比差异无显著性（P＞0.05）；中性粒细胞绝对值治疗前为（3.55±1.33）×109/L、治疗后为（3.87±0.73）×109/L，治疗前与治疗后相比差异无显著性（P＞0.05）；血小板计数治疗前为（286.90±77.49）×109/L，治疗后为（192.80±40.35）×109/L，治疗前与治疗后相比差异有显著性（P＜0.05）。视频脑电图、头颅磁共振成像均无异常，经颅多普勒示脑血管变化2例。结论肺炎支原体感染可仅表现为反复头痛，无阳性体征，仪器检查无异常。当出现反复头痛，肺炎支原体抗体阳性、血小板计数升高时要考虑到肺炎支原体感染，及时进行抗感染治疗。%ObjectiveTo explore the diagnosis and treatment of mycoplasma pneumonia infection with the only symptom of headache. Method From March 2012 to February 2015, 10 cases with headache (mycoplasma pneumonia antibody positive) in the outpatient department of pediatrics of the Second People’s Hospital of Hunan Province were analyzed. Headache was the only symptom, no positive signs; check included: magnetic resonance imaging, video electroencephalograph, transcranial Doppler, mycoplasma pneumonia antibody, blood routine test and blood biochemistry. The number of white blood cell, neutrophile granulocyte and blood platelet was compared with themselves before and after treatment.Result 10 cases with headache as the only symptom of patients, pain characteristics was recurrent, forehead, parietal, temporal based, mainly mild to moderate dull pain, bearable, exert oneself or activity aggravate. MP antibody was above 1:80, white blood cell count was (6.81±1.49)×109/L before treatment and (6.96±1.09)×109/L after treatment, there was no significant difference before and after treatment (P>0.05). Neutrophil absolute value was (3.55±1.33)×109/L before treatment and (3.87±0.73)×109/L after treatment, there was no significant difference before and after treatment (P>0.05). Platelet count was (286.9±77.49)×109/L before treatment and (192.8±40.35)×109/L after treatment, there was significant difference between before treatment and after treatment (P<0.05). There was no abnormality in video electroencephalograph and magnetic resonance imaging, transcranial Doppler showed that there was some change in cerebral vessels of 2 cases by trans cranial Doppler.Conclusion Pneumonia mycoplasma infection showed only recurrent headache, no positive signs, check the instrument without exception. It should be considered mycoplasma pneumoniae infection when mycoplasma pneumoniae antibody positive and the platelet count increased, so as to timely anti infection treatment.