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目的观察难治性肺炎支原体肺炎(RMPP)患儿肺功能的变化特点,从而进一步了解肺部病理情况,有利于临床诊疗及预后判断。方法回顾性分析2014年12月-2015年12月该院儿科住院治疗的160例肺炎支原体肺炎(MPP)患儿,将其分为RMPP组58例、轻症肺炎支原体肺炎(MMPP)组102例,所有患儿均在发病第3天及发病第14天行肺通气功能检查,将各组指标进行统计学分析。结果 RMPP组患儿在发病第3天行肺通气功能检查,代表大气道通气功能的指标[用力肺活量(FVC)、第一秒用力呼气容积(FEV1)、呼气峰流速(PEF)]及代表小气道通气功能的指标[最大中段呼气流速(MMEF 25-75)、25%肺活量位的最大呼气流速(MEF25)、50%肺活量位的最大呼气流速(MEF50)]与MMPP组患儿相比,各项指标均明显降低,差异具有统计学意义(t=-3.078、-4.654、-0.322、-4.359、-3.932和-4.283,均P<0.05);RMPP组患儿发病第14天时行肺通气功能检查,代表大气道通气功能的指标(FVC、FEV1、PEF)及代表小气道通气功能的指标(MMEF25-75、MEF25、MEF50)均低于MMPP组,差异具有统计学意义(t=-3.619、-6.425、-7.731、-7.602、-6.835和-8.357,均P<0.05);与发病第3天肺功能指标比较,RMPP组及MMPP组患儿在发病第14天所行肺功能指标均有不同程度升高,差异具有统计学意义(t=-4.846、-10.694、-6.405、-16.282、-12.076和-13.702;-3.102、-13.127、-15.559、-20.470、-14.614和-19.076,均P<0.05)。结论 RMPP患儿易出现更为严重的混合性通气功能障碍,主要为轻中度限制性通气功能障碍及重度阻塞性通气功能障碍,经有效治疗后,肺功能受损情况可逐渐恢复正常,远期预后良好。
Objective To observe the changes of pulmonary function in children with refractory mycoplasma pneumoniae pneumonia (RMPP), so as to further understand the pathological conditions of the lungs and to facilitate clinical diagnosis and prognosis. Methods A total of 160 children with Mycoplasma pneumoniae Mycoplasma pneumonia (MPP) who underwent pediatric hospitalization from December 2014 to December 2015 were retrospectively analyzed. They were divided into 58 cases of RMPP group, 102 cases of mild mycoplasma pneumoniae pneumonia (MMPP) All children were on the 3rd day of onset and 14th day of onset pulmonary function tests, the indicators of each group for statistical analysis. Results In the RMPP group, pulmonary function tests were performed on the third day after the onset of disease, which represented the indexes of airway function (FVC, FEV1, PEF) and The indices representing small airway ventilation function (maximal middle expiratory flow (MMEF 25-75), maximal expiratory flow at 25% spirometry (MEF25), maximal expiratory flow at 50% spirometry (MEF50)] correlated with MMPP (T = -3.078, -4.654, -0.322, -4.359, -3.932 and -4.283, all P <0.05). In the group of children with RMPP, the incidence of the disease was 14 The days of pulmonary function tests showed that the indexes of airway function (FVC, FEV1, PEF) and indicators of small airway ventilation (MMEF25-75, MEF25, MEF50) were lower than that of MMPP group, the difference was statistically significant t = -3.619, -6.425, -7.731, -7.602, -6.835 and -8.357, all P <0.05). Compared with the indexes of lung function on the 3rd day of onset, the RMPP group and MMPP group on the 14th day The indexes of pulmonary function increased to some extent (t = -4.846, -10.694, -6.405, -16.282, -12.076 and -13.702; -3.102, -13.1 27, -15.559, -20.470, -14.614 and -19.076, all P <0.05). Conclusions RMPP patients are more likely to have mixed severe ventilatory dysfunction, mainly mild to moderate restrictive ventilatory dysfunction and severe obstructive ventilatory dysfunction. After effective treatment, pulmonary function impairment may gradually return to normal and far Prognosis is good.