肺炎衣原体肺炎发生的相关危险因素研究(1)
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[摘要] 目的探讨重症肺炎衣原体肺炎发生的相关危险因素，以指导临床诊断及治疗。方法回顾性分析我市2008年6月～2010年5月232例住院肺炎衣原体肺炎患儿的临床资料，根据临床表现分为重症组(72例)和普通组(160例)，记录两组患儿的年龄、肺CT(或胸片)大叶性肺部病变的部位、红细胞沉降率(ESR)、急性期Cpn-Ab≥1：1280，对各项观察指标行单因素分析。结果7～9岁的儿童(P<0.05)，ESR异常增快(P<0.05)，急性期Cpn-Ab≥1：1280，大叶性肺部病变的部位发生在左肺下叶或右肺下叶(P<0.05)等为重症肺炎支原体肺炎的高危因素。结论重症肺炎衣原体肺炎患儿多见于年长儿，普通肺炎衣原体肺炎多见于年幼儿，两组相比4～6岁年龄组发病率无区别，ESR异常增快，急性期内Cpn-Ab≥1：1280，大叶性肺部病变的病变部位发生在左肺下叶或右肺下叶预示着重症肺炎支原体肺炎的发生。
[关键词]儿童；重症肺炎衣原体肺炎；高危因素
[中图分类号] R725.6 [文献标识码]B [文章编号] 1673-9701(2011)20- 39-02
Related Risk Factors of Chlamydia Pneumoniae Pneumonia
CHENRuiLIUWeiLIU JianpingFENG XiuzhiDING Nianliang
Baoli Hospital of Ningbo，Ningbo215031， China
[Abstract] ObjectiveTo identify the risk factors for the severe chlamydia pneumoniae pneumonia children and thus provide instructions for the clinical diagnosis and therapy. MethodsThe clinical data of 232 children with chlamydia pneumoniae pneumonia were retrospectively reviewed from June 2008 to May 2010 in our hospital.Based on the practical pediatrics，the subjeets were divided into two groups，the severe group(72 cases) and the common group (160 cases).The X-ranand/comparison was made between two groups in age，the manifestation of pneumonia on or CT sean，erythroeyte sedimentatlon rate(ESR)，Cpn-Ab≥l：1280 in acute stage. ResultsThe single factor regression indieated that the independent irisk faetors in cluded age range from 7 to 9(P<0.05)，erythrocyte sedimentation rate(ESR)abnormity(P<0.05)，Cpn-Ab≥l：1280 in acute stage. ConclusionAge range from 7 to 9 years，erythroeyte sedimentation rate(ESR) abnormity(P<0.05)，Cpn-Ab≥l：1280 in aeute stage was the risk factors of severe chlamydia pneumoniae pneumonia，location of the pneumonia in goup of severe myeoplasma pneumonia at lower lobe.
[Key words] Children；Chlamydia pneumoniae pneumonia；Risk factors
肺炎衣原体(Chlamydia pneumoniae，Cpn)是一类进化来源不明、严格细胞内寄生、具有独特发育周期、介于细菌与病毒之间的革兰阴性微生物，是社区获得性肺炎 (community acquired pneumonia， CAP) 重要的病原菌，其引起的肺炎常无特异性，且症状较轻。大环内醋类抗生素治疗效果好或呈自限性。近年来文献报道，Cpn感染呈重症表现逐渐增多。重症Cpn肺炎表现为大量胸腔积液、急性呼吸窘迫综合征(ARDS)、肺纤维化、阻塞性细支气管炎等，甚至危及生命；除引起呼吸道疾病外，Cpn感染尚可造成其他系统严重的并发症，如脑炎、心肌炎、肝炎、肾炎等[1]。本研究对我市2008年1月～2010年5月收治的Cpn肺炎临床资料进行回顾性对照分析 ......
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