支原体肺炎临床特征的研究.docVIP

支原体肺炎临床特征的研究 作者：陆月明1,秦玉波1,丁小丽2 作者单位：（1.解放军第455医院呼吸科，上海 200052；2.空军上海后勤训练基地门诊部,上海 200052） 【摘要】 目的 观察13例支原体肺炎患者临床特征及胸部影像学改变。 方法 对13例因发热住院的患者分别应用逆转录聚合酶链反应检测咽漱液中常见上呼吸道病原体DNA，应用免疫荧光法检测血清中常见上呼吸道病原体IgM抗体；同时进行胸部X线和CT检查。 结果 13例患者肺炎支原体IgM抗体阳性，临床主要表现为发热和干咳，胸部X线片表现为小片状密度增高影，CT表现为两肺多发或单发性斑片状密度增高影，仅1例呈大片状模糊影。阿齐霉素治疗效果较好。 结论 支原体肺炎有一定的传染性，临床症状较重，但体征缺乏特异性，胸部CT扫描较普通X线胸片更易发现病灶，血清IgM抗体检查有助于支原体肺炎的临床诊断。 【关键词】 肺炎支原体；肺炎；临床特征 Analysis of clinical characteristics of Mycoplasma pneumonia LU Yueming, QING Yubo, DING XiaoLi (Department of Respiratroy Medicine, the 455th Hopsital of PLA, Shanghai 200052, China) ［Abstract］ Objective To investigate the clinical features and changes of the chest imaging characteristics of patients with Mycoplasma pneumonia. Methods A prospective study for Mycoplasma pneumoniae infection in 13 patients with high fever was carried out. Throat washing fluid specimen were detected for common respiratory pathogens by reverse transcription polymerase chain reactions. Immunoglobulin M (IgM) to common respiratory pathogens in serum samples were detected by immunofluorescene tests. Chest X-ray and computed tomography for all the patients with fever were studied during hospitalizations. Results The major symptoms of the patients were high fever and dry cough. Serum IgM to Mycoplasma pneumoniae was positive in all patients. The most common imaging presentations were unilateral and (or) bilateral multi-focal or solitary patchy opacities in 13 patients. Pulmonary consolidation was found only in one patient. Azithromycin therapy was effective for all patients. Conclusion The patients with Mycoplasma pneumonia were contagiousness, their symptoms were severe, but no special physical signs were found. Chest computer tomograhy scan is a more sensitive technique for observation of Mycoplasma pneumonia than chest X-ray examination. Serum IgM test is a useful method for diagnosis of Mycoplasma pnuemoniea infection. ［Key words］