小兒支氣管哮喘與肺炎支原體感染的關系

仇世蓉

536000廣西北海市第四人民醫(yī)院兒科

小兒支氣管哮喘與肺炎支原體感染的關系

仇世蓉

536000廣西北海市第四人民醫(yī)院兒科

目的：探討小兒支氣管哮喘與肺炎支原體(MP)感染的關系，從而為小兒支氣管哮喘的治療方案提供指導依據(jù)。方法：2009年6月-2013年6月收治呼吸道感染并支氣管哮喘患兒100例作為觀察組，另外100例呼吸道感染患兒作為對照組，通過血清學檢查MP-IgM，確定患兒肺炎支原體感染的情況。呼吸道感染并支氣管哮喘組有48例MP-IgM陽性，將這48例患兒隨機分為兩組，一組按常規(guī)支氣管哮喘治療，另一組在常規(guī)治療的基礎上，加用阿奇霉素抗肺炎支原體感染治療，比較兩組患兒的治療效果。結(jié)果：對照組的MP-IgM陽性率20%，觀察組的MP-IgM陽性率48%，差異有統(tǒng)計學意義(P＜0.05)。常規(guī)支氣管哮喘治療組有效率37.5%，常規(guī)支氣管哮喘治療加阿奇霉素治療組有效率83.3%，差異有統(tǒng)計學意義(P＜0.05)。結(jié)論：小兒肺炎支原體感染與支氣管哮喘關系密切，對支氣管哮喘患兒應常規(guī)檢測肺炎支原體感染情況。陽性者在按哮喘常規(guī)治療同時予抗肺炎支原體感染治療，能提高療效。

小兒；支氣管哮喘；肺炎支原體；相關性

資料與方法

2009年6月-2013年6月收治呼吸道感染并支氣管哮喘發(fā)作期患者100例，作為觀察組，男73例，女27例，年齡1～13歲，呼吸道感染并支氣管哮喘的患兒的診斷均符合支氣管哮喘的診斷標準[1]。另100例同期在我院兒科住院的呼吸道感染(包括咽炎、支氣管炎、支氣管肺炎)患兒作為對照組，男78例，女22例，年齡6個月～13歲。兩組患兒在性別、年齡等方面比較，差異無統(tǒng)計學意義(P＞0.05)，且均排除了其他病原體感染，呼吸道感染組無過敏史及激素使用史。

檢測方法：兩組患兒均于起病后第7天采血2 mL，離心分離血清，置4℃冰箱保存，采用果粒凝集法測定MP-IgM，滴度＞1:80為陽性，確診為肺炎支原體感染。

治療方法：100例呼吸道感染并支氣管哮喘組有48例MP-IgM陽性，將這48例患兒隨機分為兩組，每組24例，一組按常規(guī)支氣管哮喘治療，另一組在常規(guī)支氣管哮喘治療的基礎上加用阿奇霉素序貫治療，即靜脈使用阿奇霉素10 mg/(kg·d)，連用3～5 d至體溫正常，臨床癥狀體征消失，隨后改為口服阿奇霉素10 mg/(kg·d)，連服3 d停4 d，治療期間查尿常規(guī)、肝功能，嚴密觀察有無不良反應，發(fā)現(xiàn)異常及時停藥，堅持3周，比較兩組治療方法的療效。

療效判斷標準：①顯效：1周內(nèi)咳嗽消失，肺部無陽性體征，胸部X線檢查陰性。②好轉(zhuǎn)：1周內(nèi)咳嗽明顯減輕，肺部無陽性體征，胸部X線檢查陰性。③無效：咳嗽與治療前無變化?？傆行?顯效率＋好轉(zhuǎn)率。

統(tǒng)計學方法：采用SPSS 13.0統(tǒng)計學軟件對數(shù)據(jù)進行分析，所得數(shù)據(jù)行χ2檢驗，P＜0.05，為差異有統(tǒng)計學意義。

結(jié)果

肺炎支原體感染的檢測：兩組患兒均于發(fā)病后經(jīng)血清學檢查肺炎支原體感染情況。觀察組中48例(48%)MP-IgM陽性，對照組中20例(20%)MP-IgM陽性，兩組比較，t=4.78，差異有統(tǒng)計學意義(P＜0.05)，說明肺炎支原體感染與小兒支氣管哮喘關系密切，見表1。

方法的檢測：觀察組48例MP-IgM陽性患兒中，常規(guī)治療組9例有效(有效率37.5%)，常規(guī)治療加阿奇霉素治療組20例有效(有效率83.3%)，兩組比較，t= 5.12，P＜0.05，治療方法上差異有統(tǒng)計學意義，說明支氣管哮喘伴感染時加用抗肺炎支原體感染藥能提高有效率，見表2。

The relationship between children bronchial asthma and mycoplasma pneumoniae infection

Chou Shirong
Department of Pediatrics,the Fourth People's Hospital of Beihai City,Guangxi 536000

Objective:To discuss the relationship between children bronchial asthma and mycoplasma pneumoniae infection,so as to provide guidance for the treatment schedule of children bronchial asthma.Methods:100 bronchial asthma children with respiratory tract infection were selected from June 2009 to June 2013 as the observation group.100 children with respiratory tract infection were as the control group.The situation of children mycoplasma pneumoniae infection was ensured by serological examination MP-IgM.48 cases of MP-IgM in the respiratory tract infection with bronchial asthma group were positive.The 48 children were randomly divided into two groups.One group was treated with conventional treatment of bronchial asthma,and another group was treated with azithromycin against mycoplasma pneumoniae infection on the basis of conventional treatment.The treatment effects of two groups were compared.Results:The MP-IgM positive rate of the control group was 20%;the MP-IgM positive rate of the observation group was 48%;the difference was statistically significant(P＜0.05).The effective rate of the conventional bronchial asthma treatment group was 37.5%;the effective rate of the conventional bronchial asthma treatment and azithromycin treatment group was 83.3%;the difference was statistically significant(P＜0.05).Conclusion:The relationship between the children mycoplasma pneumoniae infection and bronchial asthma is close,and the children with bronchial asthma should be given routine detection of mycoplasma pneumoniae infection situation.The positive patients are given against pneumonia mycoplasma infection according to the asthma conventional treatment at the same time,which can enhance the curative effect.

Children;bronchial asthma;Mycoplasma pneumoniae;Correlation

10.3969/j.issn.1007-614x.2015.5.50