Clinical Study Of 308 Mycoplasma Pneumoniae Pneumonia In Hospitalized Children

ObjectiveTo provide a more accurate clinical basis for the diagnosis and treatment of MPP by analyzing the epidemiology and clinical characteristics of Mycoplasma pneumoniae pneumonia in children in recent years of this area and investigating the pathogenesis of refractory MPP.MethodsWe retrospectively investigated the clinical and accessory examinational materials of 1427 chilidren diagnosed as pneumonia(including 308 MPP) admited to The Pediatric ward of Putuo District Central Hospital from 2012 to 2014. The clinical data were recorded and analyzed statistically.Results1. 308 children of MPP were collected in 2012~2014.The average incidence of the recent three years in our hospital was 21.58%. The incidence in summer was significantly higher than the other three season(p<0.01). The incidence in female(25.24%)was higher than in males(18.63%) and the difference had statistical significance(p<0.01). The incidence of school-age children(28.85%) was significantly higher than the nurseling and preschool children(p<0.01).2. Fever and cough is the most important clinical symptoms of MPP. Nurseling mainly presented with lower fever, accompanied by wheezing, and the school-age children mainly presented with high fever?no signs in lungs and the chest X-ray often showed large patches shadows. The incidence of extrapulmonary complications was 37.34%,and there was no significant difference between nurseling,preschool children and school-age children(p>0.05).3.Compared to NMPP, the percentage of CD19+B lymphocyte and the level of IgA were lower,the level of IgM was higher in MPP. The differences had statistical significance.But there were no statistical difference in the percentage of T lymphocyte, NK and the level of IgG(p>0.05).4.Compared to the children in general MPP group, the incidence of high fever,dyspnea and extrapulmonary complications in the refractory MPP group were significantly higher(p<0.01).They ofen presented no signs in lungs and the chest X-ray showed large patches shadows.The levels of Inflammatory indexes(CRP,ESR,PCT) were significantly higher(p<0.01),and the duration of fever and hospitalization were significantly longer(p<0.01).5. 127 children in the group we studied were treated with anti-infection therapy by using Azithromvcin alone.171 children were treated with the combination of β-lactam antibiotics or(and) small doses corticosteroid on the basis of Azithromvcin.10 children were treated with Clindamycin. 293 of the patients were cured, 10 were improved and 5 were failed.Conclusions1.The average incidence of the recent three years in our hospital was 21.58%. The high-incidence season of MPP in Children was summer. MPP is more commonly observed in females and school-age children.2.Children with MPP had multiple disorders of autoimmunity function.The clinical features were different in different age grade. Refractory MPP was severe and the course was longer.3.Macrolides still is the first choice for treating MPP in children.The combination of β-lactam antibiotics and(or) small doses corticosteroid on the basis of Macrolides might consider for the Severe or Refractory MPP.