Relationship Between Mycoplasma Pneumonia, Chlamydia Pneumonia And Anaphylactoid Puipura In Children

Objective: Discussion the relationship between Mycoplasma pneumonia,Chlamydia pneumonia and anaphylactoid puipura in children to improve themedication used to decrease the relapse and renal injury.Method: The samples were collected from80patients with first onsetanaphylactoid puipura which included48boys and32girls; the age was from3to15years old, came from the pediatric ward of The Second Hospital ofHebei Medical University from09-2012to02-2013. The data was collectedby observing the progress of skin purpura, digestive symptoms, articulus painand urine protein; and the relapse in follow up. At the seventh day of firstonset, draw venous blood2ml which took no anticoagulant treatment and onehour standing under4℃to run the indirect immunofluorescence to test theIgM for Mycoplasma pneumonia and Chlamydia pneumonia. Divided patientsinto2groups according to the testing result: Observation group (IgM positive)and Control group (IgM negative). There was no statistically significantdifference between two groups. During the research, both groups receivedconventional treatment such as Cetirizine, VitC, hormone-based drugs andimmunosuppressor; at the same time, anti-infectious treatment was added topatients who had fever or respiratory symptom. Azithromycin was only addedto the Observation group. Then compare the progress of skin purpura,digestive symptoms, articulus pain kidney damage and the relapse (skinpurpura relapse>=2) in two groups. The date was analyzed by spss13.0.Normal distribution and expressed by x±S. The difference between twogroups was analyzed by t-test. Skewed distribution and expressed by median.The difference between two groups was analyzed by nonparametric method.To enumeration data, used Chi square test to analyze constituent ratio betweentwo groups. Set=0.05, the value of P<0.05was regarded as statistical significance.Results:1The samples were collected from80patients, included48boysand32girls; the age was from3to15years old. Therefore, HSP used toappear mostly in school age children and male female ratio was1.5:1. Thepercentage rates for patients who had infection were51.25%. All80patientshad skin purpura which mostly symmetrical appeared at extensor arms, legsand buttocks. The patients who had skin purpura as primary symptom was29(35.25%), digestive symptoms was28(35%) which included5blood stools(+~+++), articulus pain was15(18.75%), urine protein (+~+++) and RBC(+~+++) was8(10%), relapse was12(15%). There were7of the12relapsepatients who got anaphylactic purpura nephritis in follow up.2All the patients had taken the test of blood IgM for Mycoplasma pneumoniaand Chlamydia pneumonia. The percentage of the positive for Mycoplasmapneumonia was36.25%（29/80）, and for Chlamydia pneumonia was2.5%（2/80）. There was no mixed infection.3The gender formation of observation group and control group: there were18boys and11girls in observation group; and30boys and21girls in controlgroup. Compared the two groups, the value of P>0.05was not regarded asstatistical significance（X~2=0.081，P>0.05）.4The age of observation group and control group: the average age ofobservation group is8.27±0.367, the average age of control group is8.45±0.545. Compared the two groups, the value of P>0.05was not regardedas statistical significance.（t=-0.273，P>0.05）。5The persistent period of skin purpura of observation group and control group:the median of observation group is10(5.5) and the median of control group is8(3). Compared the two groups, the value of P<0.05was regarded asstatistical significance（Z=-3.52，P<0.05）. Skin purpura of observation grouplasts longer than control group.6The hospital stays of observation group and control group: the hospital staysof the observation group was15.34±0.67days and the control group is12.59±0.357days. Compared the two groups, the value of P<0.05was regarded as statistical significance（t=-3.632,P<0.05）.The hospital stays ofobservation group was longer than control group.7The clinical manifestation; such as digestive symptoms, articulus pain andrelapse in follow up; of observation group and control group: the patients whohad digestive symptoms in observation group was17and control group was11. Compared the two groups, the value of P<0.05was regarded as statisticalsignificance（X~2=11.156，P<0.05）. Observation group had more patiens whohad digestive symptoms than control group. The patients who had articuluspain in observation group were8and control group was7. Compared the twogroups, the value of P>0.05was not regarded as statistical significance（X~2=2.331，P>0.05）. The patients who relapsed in follow up in observationgroup were9and control group was5. Compared the two groups, the value ofP<0.05was regarded as statistical significance （X~2=5.772， P<0.05）.Observation group had more patients who relapsed in follow up than controlgroup.Conclusion:1There was no difference of mycoplasma pneumoniainfection rate in different gender and age of anaphylactoid puipura patients.2The positive of IgM for Chlamydia pneumonia was less than Mycoplasmapneumonia. Chlamydia pneumonia also can be on of the pathogenic factors ofHSP, however, not the primary one.3Anaphylactoid puipura caused by mycoplasma pneumonia had longerpersistent period of skin purpura, longer hospital stays and more patients whohad digestive symptoms and relapse in follow up. Therefore, mycoplasmapneumonia made anaphylactoid puipura more complicated.