目的 探讨基层和农村地区儿童社区获得性肺炎(CAP)的流行病学、临床特征与大环内酯类抗生素疗效.方法 回顾性分析256例儿童CAP的临床表现,实验室检查结果,以及大环内酯类抗生素治疗的疗效.结果 儿童CAP病例以春、夏季高于秋、冬季,学龄期尤为显著.肺炎支原体(MP)肺炎约占28％,各年龄段间无明显差异.大多数非重症CAP的白细胞和中性粒细胞计数均在正常范围,但MP肺炎的CRP增高比例明显高于非MP肺炎.约97％的CAP肺部片状阴影均为单侧病变.97例和159例分别接受乳糖红霉素和阿奇霉素治疗,总有效率94.1％; MP肺炎与非MP肺炎在总有效率,以及乳糖红霉素和阿奇霉素疗效比较均无统计学意义.结论 大环内酯类抗生素可以作为基层或农村地区儿童CAP的首选经验性抗生素疗法.%Objectives To investigate the epidemiology and clinical manifestation of community-acquired pneumonia (CAP), and effect of macrolide antibiotics on CAP in children in community and rural areas. Methods The clinical manifestations, laboratory test results and the effect of macrolide antibiotics were retrospectively analysed in 256 children with CAP. Results CAP in children occurred more often in spring and summer than in autumn and winter, and was most common in school-age children. The morbidity rate of mycoplasma pneumonia (MP) was about 28%, with no significant differences among different age groups. The white blood cell (WBC) and neutrophil count in most of children with non-severe CAP were normal. However, the prevalence of CRP increase in MP pneumonia was higher than that in non-MP pneumonia. In about 97% cases the chest x-ray changes of CAP were unilateral. Total of 97 and 159 cases were treated with erythromycin lactobi-onate or azithromycin, respectively, and the total effective rate was 94.1%. There were no significant differences either in the total effective rate between MP pneumonia and non-MP pneumonia groups, or in the curative effect between erythromycin lactobionate and azithromycin. Conclusion Macrolide antibiotics can be used as the primary empirical antibiotics to treat CAP in children in community and rural areas.
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