ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2017, Vol. 9 ›› Issue (1): 40-43.doi: 10.3969/j.issn.1674-3865.2017.01.012

• 临床研究 • 上一篇    下一篇

小婴儿类百日咳综合征肺炎支原体感染情况及疗效分析

王江涛，王晓玲，刘榕   

  1. 450018 郑州，郑州市儿童医院小婴儿病区
  • 出版日期:2017-02-25 发布日期:2017-12-18
  • 通讯作者: 王江涛，E-mail：wangjiangtao917@126.com
  • 作者简介:王江涛(1970-)，男，医学硕士，副主任医师。研究方向：新生儿及小婴儿疾病的诊治

Infection situation of Mycoplasma pneumoniae in small infants with spastic cough and its treatment analysis

WANG Jiangtao，WANG Xiaoling，LIU Rong   

  1. Small Baby Ward of Zhengzhou Children's Hospital，Henan 450018，China
  • Online:2017-02-25 Published:2017-12-18

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摘要：
目的: 了解1～3个月小婴儿类百日咳综合征的肺炎支原体感染情况及大环内酯类药物对该类疾病的疗效分析。
方法: 2015年1月至2016年8月郑州市儿童医院小婴儿病区收治住院的类百日咳综合征患儿235例，按不同病原分为3组，即肺炎支原体感染组33例，非肺炎支原体感染组103例，病原学未明组99例。采用直接免疫荧光测定检测7种常见呼吸道病原抗体检测；采用ELISA检测患儿急性期和恢复期双份血清中肺炎支原体抗体滴度；采用血平板进行痰液细菌培养。肺炎支原体感染组和非肺炎支原体感染组给予头孢菌素与大环内酯类抗生素联合应用，病原学未明组给予头孢菌素类药物应用，疗程7 d。观察发病7 d内就诊和7 d以上就诊患儿的痉挛性咳嗽消失时间及临床疗效。
结果: 类百日咳综合征的病原体多为病毒、各种细菌等，肺炎支原体检出率14.04%(33/235)。发病≤7 d就诊患儿痉挛性咳嗽持续时间和平均住院时间分别为(5.79±0.89)d，(10.25±1.66)d，低于发病>7 d就诊的患儿(10.38±2.00)d，(13.75±1.49)d，差异均有统计学意义(P<0.05)。3组患儿治疗总有效率分别为93.94%(31/33)，91.26%(94/103)，79.80%(79/99)，差异有统计学意义(P<0.05)。
结论: 类百日咳综合征的病原体多为病毒、各种细菌等；早期就诊、早期诊断及有效治疗可缩短痉咳期及平均住院时间；大环内酯类药物用于治疗小婴儿类百日咳综合征有效率高，但应避免大环内酯类抗生素的滥用。

关键词: 类百日咳综合征, 肺炎支原体, 大环内酯类抗生素, 小婴儿

Abstract:
Objective: To understand the infection status of mycoplasma pneumonia in 1-3-month children with spastic cough and analyse effect of macrolide drugs on spastic cough.
Methods: A total of 235 cases of whooping cough syndrome in children were hospitalized for treatment from January 2015 to August 2016 in Zhengzhou Children's Hospital to different pathogens: Mycoplasma pneumoniae infection group(A，33 cases), non-Mycoplasma pneumoniae infection group(B,103 cases) and unknown pathogen group(C,99 cases). Direct immunofluorescence assay was used to detect the 7 common respiratory pathogenic antibodies. ELISA was performed to determine the titer of Mycoplasma pneumoniae antibodies in the serum at acute stage and recovery stage. Blood Agar was used to perform sputum bacteria culture. The children in group A and B were given cephalosporin and macrolides antibiotics, while those in group C were given cephalosporins, the treatment lasting 7 days. Observe the time for the spasmodic cough to disappear and the clinical effect in the children who came to hospital within 7 days of disease onset and after 7 days.
Results: The pathogens of whooping cough syndrome were mostly viruses and bacteria; the detection rate of Mycoplasma pneumoniae was 14.04%(33/235).The spasmodic cough lasted for (5.79±0.89) days in the children visiting hospital within 7 days and their average hospital stay was (10.25±1.66) days, both of which were lower than the children who visited hospital for treatment 7 days after disease onset ［(10.38±2.00) days,(13.75±1.49) days］, and the difference being significant(P<0.05). The total effective rate in the 3 groups was respectively 93.94%(31/33), 91.26%(94/103) and 79.80%(79/99), and there was statistical difference(P<0.05).
Conclusion: The pathogens of whooping cough syndrome are mostly viruses and bacteria. It can shorten the time of spasmodic cough and average hospital stay to visit hospital early, make early diagnosis and perform effective treatment. Cephalosporins are very effective in the treatment of whooping cough syndrome in small babies, but their abuse should be avoided.

Key words: Whooping cough syndrome, Mycoplasma pneumoniae, Macrolides, Small baby