肺炎支原体肺炎婴幼儿继发血小板增多症的临床特征及意义

摘要

Objectives To analyze the clinical characteristics and signiflcance of Mycoplasma pneumoniae pneumonia (MPP) combined with secondary thrombocytosis in infants and young children. Methods Clinical features, laboratory and imaging data of the infants and young children with MPP were collected, and compared between the two groups of children with and without secondary thrombocytosis. Results Sixty-seven (67) infants and young children with secondary thrombocytosis (28 males and 39 females, with onset at 2 years and 2 months after birth in average) and 269 infants and young children with normal platelet counts (138 males and 131 females, at 2 years and 3 months after birth in average) were included. Signiflcant longer durations of hospitalization(P =0.018) and fever(P =0.000), higher temperature peak(P =0.000), as well as higher morbidity of refractory MPP(P =0.001) and more complications(P =0.000)were observed in the group of MPP with secondary thrombocytosis. Moreover, the laboratory data of white blood cell count(P =0.000), C-reactive protein(P =0.000),procalcitonin (P =0.000), erythrocyte sedimentation rate(P =0.000)and higher morbidity of multiple pathogen infection(P =0.033) were observed between the two groups.Conclusions More severe clinical manifestations and higher complication morbidity could be observed in the group of MPP combined with secondary thrombocytosis, implicating the value of platelet count in clinical assessment of MPP in infants and young children at early stage.%目的 探讨肺炎支原体肺炎(MPP)婴幼儿继发血小板增多症的临床特征及其意义.方法 回顾比较MPP婴幼儿中继发血小板增多与血小板正常者的临床资料.结果 336例MPP婴幼儿中继发性血小板增多症67例,男28例、女39例,中位年龄2.16(1.75~3.16)岁;血小板正常269例,男138例、女131例,中位年龄2.25(1.92~3.25)岁.与血小板正常组相比,继发血小板增多组的住院和发热时间更长,热峰更高,白细胞计数、C反应蛋白、降钙素原和血沉水平更高,肺外并发症、难治性MPP以及多重病原感染发生率均更高,差异有统计学意义(P均<0.05).血小板计数与住院天数、发热天数、热峰、白细胞计数、C-反应蛋白及血沉指标均呈显著正相关(r=0.215~0.547,P均<0.05).结论 MPP婴幼儿中出现继发性血小板增多症者可表现出更严重的临床症状及肺外并发症.