Clinical features analysis of refractory Mycoplasma pneumoniae pneumonia in children
10.3969/j.issn.1008-9691.2017.02.005
- VernacularTitle:儿童难治性肺炎支原体肺炎临床特点分析
- Author:
Shufen MEI
;
Haili JIN
;
Sunyao WANG
- Keywords:
Refractory Mycoplasma pneumoniae pneumonia;
Mycoplasma pneumoniae;
Children
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2017;24(2):129-132
- CountryChina
- Language:Chinese
-
Abstract:
Objective To approach the clinical features of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children and provide evidence for clinical treatment.Methods A retrospective analysis was conducted.Two hundreds and twenty children with Mycoplasma pneumoniae pneumonia (MPP) admitted to the Integrated Chinese and Western Medicine Hospital of Zhejiang Province were enrolled from January 2013 to June 2016.According to the criteria of diagnosis of MPP and RMPP,the patients were divided into a general group (172 cases) and a refractory group (48 cases).Their general information,incidence of pulmonary positive sign,laboratory data,radiological findings,complications,therapeutic situations and prognoses,etc.between the two groups were observated.Results There were no significant difference in gender distribution between the two groups,but the age of the refractory group was much older than that of the general group (years:7.15 ± 1.89 vs.4.86±2.16),and the fever duration in the refractory group was obviously longer than that in the general group (days:11.17±2.82 vs.6.27±2.29,P ＜ 0.01).the levels of C-reactive protein [CRP (mg/L):46.8 ± 18.6 vs.13.5 ± 8.4],erythrocyte sedimentation rate [ESR (mm/1 h):56.9 ± 14.8 vs.28.7 ± 10.2],incidence of positive pulmonary sign [100.0％ (48/48) vs.33.7％ (58/172)],the incidence of pulmonary segmental consolidation [81.3％ (39/48) vs.27.9％ (48/172)] and incidence of extra-pulmonary complications [83.3％ (40/48) vs.16.3％ (28/172)] were all higher in refractory group than those in general group (all P ＜ 0.01).All the patients were treated with macrolide antibiotics and traditional Chinese medicine,the patients in the refractory group was additionally treated with glucocorticoids,and a few of them were treated with gamma immunoglobulin and bronchoalveolar lavage;all of them recovered well,high temperature had returned to normal and the imageology findings recovered well,then they all discharged without any sequela such as bronchiectasis and pulmonary atelectasis.Conclusions Physicians should pay more attention to the MPP patients with longer fever duration (especially longer than 10 days),serious signs and symptoms,more complications,higher CRP and ESR and severe radiological findings.Besides early application of macrolide antibiotics,rational use of glucocorticoids,gamma immunoglobulin and bronchoalveolar lavage can be considered.
