目的：探讨节段性肺炎支原体肺炎（SMPP）患儿肺功能变化及临床意义。方法：分别测定55例SMPP患儿急性期和恢复期的肺功能，包括FVC、FEV1、FEV1/FVC、PEF、FEF25%、FEF50%、FEF75%、FEF25%-75%。结果55例SMPP患儿急性期FVC、FEV1、FEV1/FVC、PEF、FEF25%、FEF50%、FEF75%及FEF25%-75%均有不同程度降低，以FEF25%、FEF50%、FEF75%和FEF25%-75%降低较为明显。恢复期各项指标均有明显改善，两组比较差异有统计学意义（P<0.05）。多部位病变SMPP患儿急性期FVC和FEV1较单个叶段病变患儿下降明显（P<0.05）。结论 SMPP患儿急性期大、小气道功能均有不同程度损伤，多表现为限制性通气障碍，小气道功能受损更明显；恢复期肺功能明显好转。多叶段病变大气道功能受损较单个叶段病变严重。
Abstract
OBJECTIVE: To investigate the changes of pulmonary functions in children with segmental Mycoplasma pneumoniae pneumonia (SMPP). METHODS: A total of 55 children with SMPP were recruited into this study. Pulmonary functions were measured at both acute and recovery phases, including FVC, FEV1, FEV1/FVC, PEF, FEF25%, FEF50%, FEF75% and FEF25%-75%. RESULTS: FVC, FEV1, FEV1 /FVC, PEF, FEF25%, FEF50%, FEF75%, and FEF25%-75% were reduced in all of the 55 cases at the acute phase. FEF25%, FEF50%, FEF75% and FEF25%-75% decreased more significantly. The indexes above mentioned were improved significantly at the recovery phase compared with the acute phase (P<0.05). During the acute phase FVC and FEV1 decreased more significantly in the group with multiple area lesions than in the group with single area lesions (P<0.05). CONCLUSIONS: Both large and small airway functions are damaged in different degrees in children with SMPP during the acute phase. More cases show restrictive ventilatory disorders and the injury of small airway function is more severe. The pulmonary function is markedly improved at the recovery phase, suggesting that the pulmonary function impairments are reversible. The pulmonary function impairments are more severe in children with multiple area lesions.
关键词
肺炎支原体 /
节段性肺炎 /
肺功能 /
儿童
Key words
Mycoplasma pneumoniae /
Segmental pneumonia /
Pulmonary function /
Child
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
［1］陆文婷.我国社区获得性肺炎的致病原的构成、耐药特点及治疗策略［J］.中国微生态学杂志，2006，18(2)：159.
［2］Okazaki N, Ohya H, Sasaki T. Mycoplasma pneumoniae isolated from patients with respiratory infection in Kanagawa Prefecture in 1976-2006: emergence of macrolideresistant strains［J］．Jpn J Infect Dis, 2007, 60(5): 325-326.
［3］胡亚美，江载芳.诸福棠实用儿科学［M ］.第7版.北京：人民卫生出版社，2002：1204-1205.
［4］曾雪飞，邹贵雄，闻锦琼，陶艳红，陈国华，何颖慧，等.肺功能检测在儿童哮喘诊治中的应用［J］.河北医学，2008,14(9):1043-1046.
［5］林士军，王桂杰，刘玉春，徐继庆，董惠翔.呼吸道发热患者肺功能检测的临床意义［J］.医药论坛杂志，2007,28(17):1-3.
［6］袁艺.肺炎支原体感染与支气管哮喘［J］.中国医刊，2009，44（2）：3-6.
［7］耿凌云，陈慧中，黄荣妍，康小会，曹玲，吕芳.不同年龄儿童肺炎支原体肺炎的临床特征［J］.实用儿科临床杂志，2008，23（16）：1255-1257.
［8］韩晓华.小儿肺炎支原体感染与哮喘［J］.实用儿科临床杂志，2009，24(10)：723-725.
［9］李芳，聂亚玲，常宏宇，王颖，张霞，曾立，等.肺炎支原体肺炎患儿肺功能变化的意义［J］.实用儿科临床杂志，2009，24（22）：1732-1736.
［10］万莉雅.肺功能检查用于诊断5岁以上儿童哮喘的临床评价［J］.中国实用儿科杂志，2009，24（4）:248-250.
［11］Chung HL, Kim SG, Shin IH. The relationship between serum endothelin (ET)-1 and wheezing status in the children with Mycoplasma pneumoniae pneumonia［J］.Pediatr Allergy Immunol, 2006, 17(4): 285-290.
［12］Wagner EM, Liu MC,Weinmann GG,Permutt S, Bleecker ER. Peripheral lung resistance in normal and asthmatic subjects［J］. Am Rev Respir Dis, 1990, 141(3): 584-588.
［13］周明娟,黄绮丹,林琳. 慢性咳嗽患者小呼吸道病变及呼吸道高反应性对哮喘的预测价值［J］.中国实用内科杂志, 2007, 27（17）：1370-1372.
［14］王晋舜．咳嗽变异性哮喘诊治探讨［J］．临床肺科杂志，2006，11(3)：369.
［15］Kim CK, Chung CY, Kim JS, Kim WS, Park Y, Koh YY. Late abnormal findings on high-resolution computed tomography after Mycoplasma pneumonia［J］. Pediatrics, 2000, 105(2)：372-378.
［16］Kjaer BB, Jensen JS, Nielsen KG, Fomsgaard A, B-ttiger B, Dohn B, et al. Lung function and bronchial responsiveness after Mycoplasma pneumoniae infection in early childhood［J］.Pediatr Pulmonol, 2008, 43(6)：567-575.
PDF(930 KB)
