不同年龄段儿童耐药重症肺炎支原体肺炎的临床特征分析<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2026.06.001

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摘要 【目的】分析不同年龄段儿童耐药重症肺炎支原体肺炎的临床特征。【方法】回顾性分析2023年8月至2024年4月湖南师范大学附属第一医院/湖南省人民医院收治的207例耐药重症肺炎支原体肺炎患儿的临床资料,按年龄分为婴幼儿组(年龄<3岁,n=40)、学龄前组(年龄3~6岁,n=73)及学龄组(年龄>6岁,n=94)。比较各组患儿临床特征。【结果】全部患儿均以发热、咳嗽为主要临床表现。婴幼儿组喘息发生率(32.50%)及合并单一病毒或细菌感染率(60.00%)显著高于其他两组,且以合并单一病毒感染为主(40.00%)。学龄前组及学龄组患儿的血清C-反应蛋白、中性粒细胞与淋巴细胞比值及乳酸脱氢酶水平均显著高于婴幼儿组(P<0.05);三组患儿D-二聚体中位数较正常值升高不明显(P>0.05),其中5例合并肺栓塞患儿D-二聚体指标显著升高(中位数25.72 mg/L)。三组患儿影像学特征均以大片实变影为主,以学龄组及学龄前组患儿尤甚,且学龄组及学龄前组患儿合并胸腔积液占比高于婴幼儿组(P<0.05); 5例合并肺栓塞均发生于学龄组及学龄前组中。本研究中99例(47.83%)患儿发生肺外并发症,以肝功能异常和心肌损伤为主,且婴幼儿组发生率更高;1例学龄期患儿出现多部位血管栓塞,经治疗后预后良好。学龄组使用四环素类药物、支气管镜灌洗治疗次数≥2次占比均高于学龄前组及婴幼儿组(P<0.05); 13.53% (28/207)患儿接受免疫支持治疗,其中婴幼儿组及学龄组患者居多(23/28),所有患儿经治疗后均好转出院。【结论】不同年龄组耐药重症肺炎支原体肺炎患儿的临床特征存在显著差异,临床医师应结合年龄分层特征优化诊疗策略,提高救治效果。

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	孙慧
	黄寒
	丁小芳
	彭力
	喻静雯

关键词 ：肺炎,支原体, 抗药性,细菌, 儿童

Abstract：【Objective】 To analyze the clinical characteristics of drug-resistant severe Mycoplasma pneumoniae pneumonia (MPP) in children of different age groups. 【Methods】 A retrospective analysis was performed on the clinical data of 207 children diagnosed with drug-resistant severe MPP admitted to The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital) from August 2023 to April 2024. The enrolled children were divided into three groups according to age: infant group (age<3 years old, n=40), preschool group (age 3-6 years old, n=73) and school-age group (age>6 years old, n=94). The clinical characteristics were compared among the three groups. 【Results】 Fever and cough were the main clinical manifestations in all children. The infant group had a significantly higher incidence of wheezing (32.50%) and single viral or bacterial co-infection rate (60.00%) than the other two groups, with single viral infection (40.00%) as the predominant complication. The levels of serum C-reactive protein, neutrophil-to-lymphocyte ratio and lactate dehydrogenase in the preschool and school-age groups were significantly higher than those in the infant group (P<0.05). The median D-dimer level of the three groups showed no obvious elevation compared with the normal range (P>0.05), while significantly increased D-dimer level (median: 25.72 mg/L) was observed in 5 children complicated with pulmonary embolism. Massive pulmonary consolidation was the main imaging feature in all groups, especially in the preschool and school-age groups, which also had a higher proportion of pleural effusion than the infant group (P<0.05). All 5 cases of pulmonary embolism occurred in preschool and school-age children. Extrapulmonary complications occurred in 99 children (47.83%), mainly including liver dysfunction and myocardial injury, with a higher incidence in the infant group. One school-age child developed multi-site vascular embolism and achieved a good prognosis after treatment. The school-age group had higher proportions of children receiving tetracycline antibiotics and undergoing bronchoscopic lavage for no less than twice (P<0.05). A total of 28 children (13.53%) received immune supportive therapy, most of whom were from the infant and school-age groups (23/28). All children improved and were discharged after treatment. 【Conclusion】 There are significant differences in clinical characteristics of children with drug-resistant severe MPP across different age groups. Clinically, individualized diagnosis and treatment strategies should be optimized based on age stratification characteristics to improve the efficacy of clinical treatment.

Key words： Pneumonia, Mycoplasma Drug Resistance, Bacterial Child

收稿日期: 2026-02-11

中图分类号:

R725.631

基金资助:*湖南省卫生健康高层次人才重大科研专项资助(编号:R2023110)

通讯作者: **E-mail:huanghanpd@126.com

引用本文:

孙慧, 黄寒, 丁小芳, 彭力, 喻静雯. 不同年龄段儿童耐药重症肺炎支原体肺炎的临床特征分析^*[J]. 医学临床研究, 2026, 43(6): 881-884.
SUN Hui, HUANG Han, DING Xiaofang, PENG Li, YU Jingwen. Analysis of Clinical Characteristics of Drug-Resistant Severe Mycoplasma Pneumoniae Pneumonia in Children of Different Age Groups. JOURNAL OF CLINICAL RESEARCH, 2026, 43(6): 881-884.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.06.001 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I6/881

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