儿童支原体肺炎肺功能和血嗜酸性粒细胞的变化及意义

摘要

Objective To observe the changes of lung function and the perentage of blood eosinophil (EOS)in children with mycoplasma pneumoniae pneumonia (MPP).Methods The general pulmonary function and blood EOS%of 22 children with MPP during the acute and convalescent phase and 50 healthy children were tested.Results The general pulmonary function of 22 children with MPP during the acute phase were reported that 3 cases(13.94%)were normal and 19 cases(86.36%)were abnormal.Among them 10 cases(45.45%)had smal airway dysfunction,2 cases(9.09%)had obstructive ventilatory disturbance,6 cases (27.27%)had restricted ventilatory disturbance,1 case (13.64%)had mixed ventilatory disturbance.During the convalescent phase,4 cases had light restricted ventilatory disturbance,10 cases had smal airway dysfunction,others were normal.None of the healthy children had abnormal report.During the acute phase,FEV1%pred,FVC%pred,FEF50%pred,FEF75%pred, MMEF%pred were significantly lower than the healthy children.In convalescent phase,FVC%pred was normal,other indexes were stil lower than healthy children.The EOS%in MPP group during the convalescent phase were higher than the acute phase and the healthy children.Conclusion MPP can result in EOS inflammation and impaired pulmonary function,especial y obstruction in smal airway.%目的：观察儿童肺炎支原体肺炎(MPP)的常规肺功能和血嗜酸性粒细胞(EOS)比例的变化规律,并探讨其临床意义。方法采用JEAGER公司生产的MasterScreen IOS肺功能仪检测22例MPP急性期、恢复期患儿和50例门诊健康体检儿童的常规肺功能,以及检测血EOS%,并加以比较。结果22例MPP患儿急性期肺功能检查中有3例(13.64%)肺通气功能大致正常,其余19例(86.36%)有不同程度的肺功能损害,表现为小气道病变有10例(45.45%),阻塞性通气功能障碍有2例(9.09%),限制性通气功能障碍6例(27.27%),混合性通气功能障碍1例(4.55%)。恢复期仍有4例(18.18%)表现为轻度限制性通气功能障碍,10例(45.45%)表现为小气道病变,其余肺功能恢复正常(36.36%)。健康对照组无1例肺通气功能检查异常。 MPP恢复期儿童血EOS%显著高于急性期及健康儿童(P<0.05)。结论 MPP患儿存在EOS血症,急性期大小气道通气功能均有损害,恢复期除用力肺活量占预计值百分比(FVC/Pred%)恢复正常外,其他指标仍显著低于正常组。我们认为动态观察MPP患儿肺功能和血EOS变化,对判断儿童MPP预后有一定临床意义。