小儿支气管哮喘与肺炎支原体感染的关系

仇世蓉

536000广西北海市第四人民医院儿科

小儿支气管哮喘与肺炎支原体感染的关系

仇世蓉

536000广西北海市第四人民医院儿科

目的：探讨小儿支气管哮喘与肺炎支原体(MP)感染的关系，从而为小儿支气管哮喘的治疗方案提供指导依据。方法：2009年6月-2013年6月收治呼吸道感染并支气管哮喘患儿100例作为观察组，另外100例呼吸道感染患儿作为对照组，通过血清学检查MP-IgM，确定患儿肺炎支原体感染的情况。呼吸道感染并支气管哮喘组有48例MP-IgM阳性，将这48例患儿随机分为两组，一组按常规支气管哮喘治疗，另一组在常规治疗的基础上，加用阿奇霉素抗肺炎支原体感染治疗，比较两组患儿的治疗效果。结果：对照组的MP-IgM阳性率20%，观察组的MP-IgM阳性率48%，差异有统计学意义(P＜0.05)。常规支气管哮喘治疗组有效率37.5%，常规支气管哮喘治疗加阿奇霉素治疗组有效率83.3%，差异有统计学意义(P＜0.05)。结论：小儿肺炎支原体感染与支气管哮喘关系密切，对支气管哮喘患儿应常规检测肺炎支原体感染情况。阳性者在按哮喘常规治疗同时予抗肺炎支原体感染治疗，能提高疗效。

小儿；支气管哮喘；肺炎支原体；相关性

资料与方法

2009年6月-2013年6月收治呼吸道感染并支气管哮喘发作期患者100例，作为观察组，男73例，女27例，年龄1～13岁，呼吸道感染并支气管哮喘的患儿的诊断均符合支气管哮喘的诊断标准[1]。另100例同期在我院儿科住院的呼吸道感染(包括咽炎、支气管炎、支气管肺炎)患儿作为对照组，男78例，女22例，年龄6个月～13岁。两组患儿在性别、年龄等方面比较，差异无统计学意义(P＞0.05)，且均排除了其他病原体感染，呼吸道感染组无过敏史及激素使用史。

检测方法：两组患儿均于起病后第7天采血2 mL，离心分离血清，置4℃冰箱保存，采用果粒凝集法测定MP-IgM，滴度＞1:80为阳性，确诊为肺炎支原体感染。

治疗方法：100例呼吸道感染并支气管哮喘组有48例MP-IgM阳性，将这48例患儿随机分为两组，每组24例，一组按常规支气管哮喘治疗，另一组在常规支气管哮喘治疗的基础上加用阿奇霉素序贯治疗，即静脉使用阿奇霉素10 mg/(kg·d)，连用3～5 d至体温正常，临床症状体征消失，随后改为口服阿奇霉素10 mg/(kg·d)，连服3 d停4 d，治疗期间查尿常规、肝功能，严密观察有无不良反应，发现异常及时停药，坚持3周，比较两组治疗方法的疗效。

疗效判断标准：①显效：1周内咳嗽消失，肺部无阳性体征，胸部X线检查阴性。②好转：1周内咳嗽明显减轻，肺部无阳性体征，胸部X线检查阴性。③无效：咳嗽与治疗前无变化。总有效率=显效率＋好转率。

统计学方法：采用SPSS 13.0统计学软件对数据进行分析，所得数据行χ2检验，P＜0.05，为差异有统计学意义。

结果

肺炎支原体感染的检测：两组患儿均于发病后经血清学检查肺炎支原体感染情况。观察组中48例(48%)MP-IgM阳性，对照组中20例(20%)MP-IgM阳性，两组比较，t=4.78，差异有统计学意义(P＜0.05)，说明肺炎支原体感染与小儿支气管哮喘关系密切，见表1。

方法的检测：观察组48例MP-IgM阳性患儿中，常规治疗组9例有效(有效率37.5%)，常规治疗加阿奇霉素治疗组20例有效(有效率83.3%)，两组比较，t= 5.12，P＜0.05，治疗方法上差异有统计学意义，说明支气管哮喘伴感染时加用抗肺炎支原体感染药能提高有效率，见表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