肺炎支原体肺炎急性期X线与HRCT肺部特征及诊断价值对比

doi:10.7517/issn.1674-0475.210118

摘要/Abstract

摘要： 本文探讨肺炎支原体肺炎（MPP）患儿急性期X线与高分辨率CT（HRCT）肺部特征及诊断价值。选取MPP患儿120例，根据检查方法分为X线组（n=70）和HRCT组（n=50），其中X线组接受胸部X线检查，HRCT组接受HRCT检查。HRCT组检查MPP诊断率为92.00%，高于X线组（P<0.05）；X线影像主要为间质性浸润，其次表现为肺门影增大，肺纹理增粗、增多等；HRCT检查主要为不均匀性高密度肺实变影，包括小叶实变影、节段性实变影和大叶性实变影；HRCT组大叶性实变影患儿FEF₂₅、FEF₇₅占预计值比例明显低于小叶实变影、节段性实变影（P<0.05）；节段性实变影患儿FEF₇₅占预计值比例低于小叶实变影（P<0.05）。HRCT在MPP患儿诊断中有较好的应用价值，且患儿HRCT实变影与肺功能有一定关系。

关键词: 肺炎支原体肺炎, 急性期, X线, 高分辨率CT, 诊断价值

Abstract: The purpose of this study is to investigate the lung characteristics and diagnostic value of X-ray and high-resolution CT (HRCT) in children with mycoplasma pneumoniae pneumonia (MPP). One hundred and twenty children with MPP who were treated were selected and divided into X-ray group (n=70) and HRCT group (n=50). The X-ray group received chest X-ray examination, and the HRCT group received HRCT examination. The MPP diagnosis rate of HRCT group was 92.00%, which was higher than that of X group (P<0.05). The X-ray images were mainly interstitial infiltration, followed by hilar shadow enlargement, lung texture thickening and increase, etc. HRCT examination mainly consisted of non-uniform high-density lung consolidation shadows, including lobular consolidation shadows, segmental consolidation shadows and macrophylla consolidation shadows. In the HRCT group, FEF₂₅ and FEF₇₅ accounted for the projected value of macrophylla consolidation shadows were significantly lower than lobular consolidation and segmental consolidation (P<0.05). The proportion of FEF₇₅ in children with segmental consolidation shadow was lower than that of lobular consolidation shadow (P<0.05). HRCT has a good application value in the diagnosis of MPP, and the consolidation shadow of HRCT has a certain relationship with lung function.

Key words: Mycoplasma pneumoniae pneumonia, acute stage, X-ray, high resolution CT, diagnostic value

赵兰花, 杨淑慧, 马琳. 肺炎支原体肺炎急性期X线与HRCT肺部特征及诊断价值对比[J]. 影像科学与光化学, 2021, 39(4): 584-588.

ZHAO Lanhua, YANG Shuhui, MA Lin. Comparison of Pulmonary Characteristics and Diagnostic Value of X-ray and HRCT in Children with Acute Mycoplasma Pneumoniae Pneumonia[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2021, 39(4): 584-588.

参考文献

[1] 贝政平, 李毅, 王莹, 等. 儿科疾病诊断标准[M]. 北京:科学出版社, 2007.
[2] Xu W H, Yang H M, Liu H, et al. Bronchoalveolar lavage T cell cytokine profiles and their association with lung function in children with mycoplasma pneumoniae-associated bronchiolitis obliterans[J]. Pediatric Pulmonology, 2020,55(8):2033-2040.
[3] Yu Y F, Wang J, Han R, et al. Mycoplasma hyopneumoniae evades complement activation by binding to factor H via elongation factor thermo unstable (EF-Tu)[J]. Virulence, 2020,11(1):1059-1074.
[4] Oishi T, Fukuda Y, Wakabayashi S, et al. Low prevalence of Chlamydia pneumoniae infections during the mycoplasma pneumoniae epidemic season:results of nationwide surveillance in Japan[J]. Journal of Infection and Chemotherapy, 2020,26(11):1116-1121.
[5] Varghese S M, Kerkar V V. Macrolide resistant mycoplasma pneumoniae in community acquired pneumonia[J]. The Indian Journal of Pediatrics, 2020,87(11):958.
[6] 胡亚美, 江载芳. 诸福棠实用儿科学[M]. 北京:人民卫生出版社, 2005.
[7] 霍现洛, 薛小花, 袁淑绘, 等. 胸部CT在2019冠状病毒病和支原体肺炎患者早期鉴别诊断中的价值[J]. 浙江大学学报(医学版), 2020,49(4):468-473.
[8] Oliva A, Siccardi G, Migliarini A, et al. Co-infection of SARS-CoV-2 with Chlamydia or mycoplasma pneumoniae:a case series and review of the literature[J]. Infection, 2020,48(6):871-877.
[9] 许侃. 小儿肺炎支原体肺炎应用X射线和CT检查的临床价值及影像学特征[J]. 中国妇幼保健, 2020,35(16):3105-3108.
[10] Chun Y L, Yu T Y, Chang L Y, et al. Multiple-locus variable-number tandem-repeat analysis (MLVA) of macrolide-susceptible and -resistant mycoplasma pneumoniae in children in Taiwan[J]. Journal of the Formosan Medical Association, 2020,119(10):1539-1545.
[11] 李娅, 王倩, 袁刚, 等. 儿童重症肺炎支原体肺炎的CT表现与预后的相关性[J]. 放射学实践, 2020,35(2):234-237.
[12] Mirijello A, La Marca A, D'Errico M M, et al. Venous thromboembolism during mycoplasma pneumoniae infection:case report and review of the literature[J]. European Review for Medical and Pharmacological Sciences, 2020,24(19):10061-10068.
[13] 王玮, 仲颖岚. CT鉴别小儿肺炎支原体肺炎及肺炎支原体肺炎合并肺炎链球菌性肺炎的价值观察[J]. 中国CT和MRI杂志, 2020,18(12):74-76.
[14] Rivaya B, Jordana-Lluch E, Fernández-Rivas G, et al. Macrolide resistance and molecular typing of mycoplasma pneumoniae infections during a 4 year period in Spain[J]. Journal of Antimicrobial Chemotherapy, 2020,75(10):2752-2759.
[15] 谢国栋, 邓倩烨, 时晨辉, 等. 低龄肺炎支原体肺炎患儿肺功能变化及HRCT表现特点分析[J]. 中国CT和MRI杂志, 2020,18(10):34-36.
[16] Morozumi M, Tajima T, Sakuma M, et al. Sequence type changes associated with decreasing macrolide-resistant mycoplasma pneumoniae, Japan[J]. Emerging Infectious Diseases, 2020,26(9):2210-2213.
[17] 孟盈盈, 肖新广, 张欣, 等. 新型冠状病毒肺炎和支原体肺炎的临床及高分辨率CT表现比较[J]. 中国中西医结合影像学杂志, 2020,18(4):325-327, 330.
[18] Hubara E, Golan-Tripto I, Ben-Shimol S, et al. Pneumopericardium in a neonate with respiratory syncytial virus and mycoplasma pneumoniae bronchiolitis:an unusual complication with unusual timing[J]. Journal of Paediatrics and Child Health, 2020,56(10):1629-1631.
[19] Zhou Y J, Wang J, Chen W J, et al. Impact of viral coinfection and macrolide-resistant mycoplasma infection in children with refractory mycoplasma pneumoniae pneumonia[J]. BMC Infectious Diseases, 2020,20(1):633-642.
[20] 蔡沁馨, 李红林, 王笑转, 等. 60例成人支原体肺炎的临床及CT影像特征[J]. 暨南大学学报(自然科学与医学版), 2020,41(4):330-335.