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AIM To investigate the clinical effects of Feining Paidu Decoction combined with conventional treatment on patients with Mycoplasma pneumoniae lobar pneumonia.METHODS Ninety patients were randomly assigned into control group(45 cases)for 2-week intervention of conventional treatment,and observation group(45 cases)for 2-week intervention of both Feining Paidu Decoction and conventional treatment.The changes in clinical effects,TCM syndrome scores,inflammatory indices(WBC,N,CRP,ESR,PCT),inflammatory cytokines(TNF-α,IL-6,IL-8),coagulation indices(PLT,TT,PT,APTT,Fib,D-D),pulmonary imaging intergal and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P<0.05).After the treatment,the two groups displayed decreased TCM syndrome scores,inflammatory indices,inflammatory cytokines,PLT,pulmonary imaging intergal(P<0.05),especially for the observation group(P<0.05);the observation group exhibited prolonged TT,PT,APTT(P<0.05),and decreased Fib,D-D(P<0.05),which were more obvious than those in the control group(P<0.05).No significant difference in incidence of adverse reactions was found between the two groups(P>0.05).CONCLUSION For the patients with Mycoplasma pneumoniae lobar pneumonia,Feining Paidu Decoction combined with conventional treatment can safely and effectively alleviate clinical symptoms,and improve inflammatory responses,coagulation functions.
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Objective To study the clinical efficacy of using bronchoalveolar lavage in severe lobar pneumonia and to analyze the high-risk factors affecting the duration of the disease.Methods The clinical data of children with severe lobar pneumonia diagnosed in the Department of Pediatrics,the First Affiliated Hospital of Shihezi University from January 2018 to January 2022 were retrospectively collected,and the children in the lavage group and the control group were matched 1:1 according to whether bronchoalveolar lavage was performed using the propensityscore matching(PSM)method to compare the therapeutic effects of the two groups.At the same time,the children in the lavage group were divided into the long-duration group and the short-duration group according to whether the duration of the disease was more than 2 weeks,and the reasons for the difference in the duration of the disease between the two groups were analyzed.Results ① After treatment,the children in the lavage group had cough relief time,fever reduction time,lung rales disappearance time,lung imaging manifestations reduction time,white blood cell(WBC),neutrophil to lymphocyte ratio neutrophil-to-lymphocyte ratio(NLR),C-reactive protein(CRP),erythrocytes sedimentation rate(ESR),and procalcitonin(PCT)were all lower than those in the control group,and the differences were statistically significant(P<0.05).② In the lavage group,the CRP,lactate dehydrogenase(LDH),and fever peak value of children in the long-course group were significantly higher;The proportions of multi-pulmonary lobe infection,combined pleural effusion,and multiple pathogen infections were significantly higher than those in the short-course group.The difference was statistically significant among disease course groups(P<0.05).③ Two-category Logistic and receiver operating characteristic curve(ROC curve)analysis showed that LDH and CRP were independent risk factors for the disease duration in children in the lavage group>2 weeks,and the optimal critical values of LDH and CRP for predicting a disease duration of>2 weeks in children with severe lobar pneumonia were 333U/L and 32.6mg/L,respectively.Conclusion ① Bronchoalveolar lavage can shorten the treatment time of children with lobar pneumonia,speed up the recovery of inflammation,and significantly improve the efficacy.② Multiple pathogenic mixed infections,concurrent pleural effusion,LDH≥333 U/L,and CRP≥32.6 mg/L are independent risk factors for the disease duration>2 weeks after alveolar lavage in children with lobar pneumonia.We need to be alert to the possibility of prolonged disease course.
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@#Abstract: Objective To explore the correlation between levels of hypersensitive C-reactive protein (hs-CRP) and procalcitonin (PCT) in serum and alveolar fluid and severity of disease in children with lobar pneumonia. Methods A total of 112 children diagnosed with lobar pneumonia from September 2020 to September 2021 were selected as the research subjects. The levels of hs-CRP and PCT in serum and alveolar fluid were detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). The children were divided into severe group (clinical pulmonary infection score, CPIS≥6 points) and mild group (CPIS<6 points) according to the severity of disease, and further classified into good prognosis group (cured, improved) and poor prognosis group (uncured) according to their treatment outcomes. The correlation of levels of hs-CRP and PCT in serum and alveolar fluid with disease severity in children and their predictive value on prognosis were analyzed. Results The levels of serum hs-CRP and PCT in severe group were (17.73±3.26) μg/L and (8.59±1.84) μg/L, which were significantly higher than corresponding (12.58±3.09) μg/L, and (5.62±1.59) μg/L in mild group (P<0.05); the levels of hs-CRP and PCT in alveolar fluid in severe group were (21.25±4.18) μg/L and (8.71±1.54) μg/L, which were significantly higher than corresponding (13.79±2.76) μg/L and (5.38±1.69) μg/L in mild group (P<0.05). The levels of hs-CRP and PCT in serum and alveolar fluid were positively correlated with CPIS scores (r=0.398, 0.441; 0.475, 0.586, P<0.05). The levels of hs-CRP and PCT in serum in poor prognosis group were (20.09±4.20) μg/L and (13.35±2.91) μg/L, which were significantly higher corresponding (8.75±2.19) μg/L and (6.28±1.31) μg/L in good prognosis group (P<0.05). The levels of hs-CRP and PCT in alveolar fluid were (23.70±4.29) μg/L and (10.73±2.04) μg/L, which were higher than corresponding (15.08±3.56) μg/L and (5.79±1.10) μg/L in poor prognosis group (P<0.05). There was no significant difference in AUC between combined detection of serum indicators and combined detection of alveolar perfusion fluid indicators in predicting the prognosis of children with lobar pneumonia (P>0.05). Conclusions The levels of hs-CRP and PCT in serum and alveolar fluid of children with lobar pneumonia are significantly increased and positively correlated with the severity of disease. However, the predictive value of the combined detection of serum indicators and combined detection of alveolar perfusion fluid indicators for the prognosis of children with lobar pneumonia is comparable.
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Objective To explore the clinical efficacy of ginseng schisandra decoction in children with lobar pneumonia(lung spleen deficiency syndrome)induced by mycoplasma pneumoniae infection and improvement of inflammatory indicators.Method 84 children with lobar pneumonia(lung spleen deficiency syndrome)caused by mycoplasma infection admitted to the First Clinical Hospital of Jilin Academy of Traditional Chinese Medicine from January 2020 to July 2022 were selected and randomly divided into two groups with 42 cases each.The conventional group was treated according to the traditional treatment plan,while the combined group was treated with ginseng and schisandra decoction in addition to the traditional treatment plan.After 7 days,compare the differences in traditional Chinese medicine syndrome scores,clinical efficacy,inflammatory indicators,and total incidence of adverse reactions between the two groups of children.Result The results showed that the traditional Chinese medicine syndrome score and inflammatory indicators in the combined group were lower than those in the conventional group(P<0.05),and the clinical efficacy level distribution was better than that in the conventional group(P<0.05).The total effective rate was higher than that in the conventional group(P<0.05),and there was no difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion In the treatment of children with lobar pneumonia(lung spleen deficiency syndrome)caused by Mycoplasma pneumoniae infection,the modified Ginseng Wuweizi decoction has a positive therapeutic effect and good safety,and is worth promoting.
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@#Abstract: Objective To analyze the clinical characteristics of children with lobar pneumonia and the distribution of pathogens in bronchoalveolar lavage fluid (BALF) collected from these patients, hence providing a scientific basis for their precise diagnosis and treatment. Methods A total of 115 children diagnosed with lobar pneumonia from August 2019 to August 2022 at Suining Central Hospital were screened as the research subjects. The clinical manifestations and occurrence of complications in the patients were investigated. All the children underwent bronchoalveolar lavage after admission, and BALF samples were collected. Fluorescence quantitative PCR was adopted to detect and analyze the distribution and clinical characteristics of Streptococcus pneumoniae (SP) and other related pathogenic microorganisms in BALF specimens. Results Among the 115 pediatric patients with lobar pneumonia, the occurrence of manifestations or complications including involvement of ≥2 lung lobes, myocardial damage, pleural effusion, abnormal liver function, digestive system involvement, nervous system involvement, rash, renal function impairment, and lung atelectasis were observed in 46, 46, 39, 33, 18, 17, 11, 5, and 4 cases, respectively. The pathogen positivity rate in the BALF samples of the 115 patients was 87.0% (100/115), with 81 cases of single infection and 19 cases of mixed infection. A total of 121 strains of pathogens were isolated, including 83 strains of Mycoplasmal pneumonia (MP) (accounting for 68.6%) and SP(13.2%). The differences in the detection rates of HI, MP, RSV strains among different age groups were statistically significant (χ2=8.834, 19.454, 10.284, P<0.05), while the differences in the infection rates of SP, KP, CP, and ADV were not statistically significant (χ2=3.393, 2.67, 0.565, 0.097, P>0.05). The MP pneumonia group showed significantly higher incidence of complications such as pleural effusion, nervous system involvement, and abnormal liver function than the non-MP pneumonia group (χ2=3.925, 4.195, and 4.513, P<0.05). The highest pathogen detection rate was in winter, accounting for 33.91%. Conclusions MP is the most common pathogen in BALF of children with lobar pneumonia. There is variation in the pathogen detection rate among different age groups and seasons. Those with combined infections were more prone to complications, which is worthy of attention by clinicians.
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Objective To investigate the therapeutic effect of cefradine on lobar pneumonia and its influence on the prognosis of patients with lobar pneumonia. Methods 90 cases of lobar pneumonia patients from December 2015 to May 2017 were randomly divided into the study group and the control group, with 45 cases in each group. The study group was treated with latamoxef on the basis of routine treatment, the control group was treated with cefoperazone on the basis of routine treatment ,recorded in two groups after 2 weeks of treatment. The clinical efficacy,drug related adverse reactions occur of the two groups were recorded after two weeks of treatment. Results The total effective rate in the study group(93.33%) was significantly higher than that of the control group(73.33%)(P<0.05). There was no significant difference in the incidence of drug-related adverse reactions between the two groups during the treatment period. Conclusion The application of latamoxet in the treatment of lobar pneumonia can significantly improve the clinical efficacy of patients, and is conducive to the protection of their prognosis and quality of life.
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Objective To investigate the therapeutic effect of cefradine on lobar pneumonia and its influence on the prognosis of patients with lobar pneumonia. Methods 90 cases of lobar pneumonia patients from December 2015 to May 2017 were randomly divided into the study group and the control group, with 45 cases in each group. The study group was treated with latamoxef on the basis of routine treatment, the control group was treated with cefoperazone on the basis of routine treatment ,recorded in two groups after 2 weeks of treatment. The clinical efficacy,drug related adverse reactions occur of the two groups were recorded after two weeks of treatment. Results The total effective rate in the study group(93.33%) was significantly higher than that of the control group(73.33%)(P<0.05). There was no significant difference in the incidence of drug-related adverse reactions between the two groups during the treatment period. Conclusion The application of latamoxet in the treatment of lobar pneumonia can significantly improve the clinical efficacy of patients, and is conducive to the protection of their prognosis and quality of life.
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This study was aimed to investigate the clinical effect and safety of Qing-Fei Jie-Du (QFJD) decoction on treating lobar pneumonia in children.Ninety cases of children diagnosed with lobar pneumonia in hospital were selected by double-centre,random and control method.Cases were divided into the test group (60 cases) and the control group (30 cases.The ratio between the test group and the control group was 2∶1.It can fully demonstrate the effect of the test group without any influence on the statistical analysis).Children of the control group were given conventional medicine with placebo,while children of the test group were given conventional medicine with modified QFJD decoction.The treatment course was 2 weeks.The clinical symptoms including fever,cough,lung rale,lung image (X-ray or CT scan),laboratorial index and safety were compared between two groups.The results showed that the recovery rate of the test group was 81.7％;and the recovery rate of the control group was 66.7％.The difference between them was statistically significant (P＜0.05).The comparison of safety between two groups indicated that the treatment of the test group was safer than control group with statistical difference (P＜0.05).It was concluded that modified QFJD decoction had a significant clinical effect and was very safe in the treatment of children with lobar pneumonia.
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Objective To investigation effect of glucocorticoid combined with Qingkailing injection on lobar pneumonia IL-10 and serum TNF-levels.Methods 120 cases of lobar pneumonia in children were selected respiratory department fromasin our hospital in December 2012 to December 2014 as the object of study, were divided into control group and observation group, control group were treated with dexamethasone sodium phosphate injection,the observation group in the control group based on the combined with Qingkailing injection, serum IL-10, TNF-a level and curative effect were compared between the two groups pre-and post-treatment in patients.Results The total effective rate of the observation group was 86.67%, higher than that of the control group, the total effective rate was 70%(P <0.05).Before treatment, the two groups of patients with TNF-αand IL-10 were not statistically significant difference.After treatment, the two groups of patients with TNF-αand IL-10 were decreased, and lower than the control group (P<0.05) .Conclusion Glucocorticoid combined with Qingkailing injection can reduce serum IL-10, TNF-alpha level in lobar pneumonia,has a definite effect.
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Objective To investigate the pathogenic types and clinical features of children with lobar pneumonia. Methods Eighty children with lobar pneumonia diagnosed from April 2013 to May 2015 were enrolled. Bronchoalveolar lavage lfuid (BALF) of patients were collected. FQ-PCR was used to detect and analyze pathogens in BALF. Results In 80 cases, 59 cases were Mycoplasma pneumoniae, and 2 cases were Chlamydia pneumoniae, 12 cases were Streptococcus pneumoniae, 1 case was Klebsiella pneumoniae, 8 cases were adenovirus, 1 case was respiratory syncytial virus, 14 cases were of mixed infection. The prevalence of MP lobar pneumonia in children of 7-14 years old age group were higher than that of other age groups. Conclusions The pathogen of children with lobar pneumonia varied from Mycoplasma pneumoniae, Chlamydia pneumoniae, bacteria, virus and so on, and Mycoplasma pneumoniae was the common pathogen in lobar pneumonia.
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Objective To analyze the effect of fiber bronchoscope bronchial lavage technique for the children with lobar pneumonia.Methods 110 cases of lobar pneumonia were divided into the bronchial lavage group (55 cases) and the control group (55 cases).The clinical effect of two groups was observed.Results The tempera-ture recovery time, chest rales recovery time, clinical presentation time, X -ray change recovery time of bronchial lavage groups were significantly shorter than those of the control group (all P<0.05).The total effective rate of the lavage group was 85.5%,which was 65.5% of the control group (χ2 =10.632,P <0.01).Conclusion The children with lobar pneumonia taken bronchoscopy and bronchoalveolar lavage reached the diagnosis and achieved the goal of treatment,it could significantly improve the clinical symptoms,promote disease recovery,conducive to rehabili-tation of children.
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PURPOSE: This study was conducted to evaluate the difference of clinical characteristics of pneumonia in children caused by Mycoplasma pneumoniae, according to their chest radiographic patterns. METHODS: We analyzed medical records of 921 children who were admitted to Soonchunhyang University Buchon Hospital due to M. pneumoniae pneumonia from January 2008 to December 2011. Enrolled children were divided into 2 groups by radiological patterns: lobar/lobular pneumonia group (group 1) and broncho/interstitial pneumonia group (group 2). RESULTS: The number of patients in group 1 was 295 (32%) and in group 2, 626 (68%). Lobar/lobular pneumonia occurred in older children compared to broncho/interstitial pneumonia (mean age, 6.4 years vs. 4.2 years; P=0.00). Group 1 had significantly longer durations of fever and hospitalization than group 2. The frequency of pleural effusion was significantly higher in group 1. Erythrocyte sedimentation rate and C-reactive protein values were higher in group 1. Coinfections with respiratory viruses were more frequent in group 2. The history of allergic diseases were more common in group 2 (P=0.006). In 2011, lobar/lobular pneumonia was more frequent and the duration of fever was longer compared with 2008-2010. CONCLUSION: In M. pneumoniae pneumonia, patients with lobar/lobular pneumonia were more older and had more severe clinical features and laboratory findings. Because there was an outbreak with severe clinical course in 2011, we wonder that the outbreak was related to the macrolide resistant M. pneumoniae. Careful attention about clinical course and consequences of patients with lobar/lobular pneumonia is required.
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Enfant , Humains , Sédimentation du sang , Protéine C-réactive , Co-infection , Fièvre , Hospitalisation , Dossiers médicaux , Mycoplasma pneumoniae , Mycoplasma , Épanchement pleural , Pneumopathie infectieuse , Pneumopathie à mycoplasmes , Radiographie thoraciqueRÉSUMÉ
PURPOSE: We aimed to evaluate the clinical characteristics and etiological organisms associated with lobar/lobular pneumonia in Korean children. METHODS: Children hospitalized due to radiographically confirmed lobar/lobular pneumonia were evaluated prospectively between June 2006 and May 2008. Anti-Mycoplasma pneumoniae IgM/IgG (at admission and follow-up), blood cultures, throat swabs for bacterial detection or sputum culture, respiratory viruses (Respiratory syncytial virus, Adenovirus and Influenza A/B) antigen testing, and urinary antigen testing for S. pneumoniae were performed. RESULTS: Two hundred eighty-eight immunocompetent children (mean age, 5.9 years) were enrolled. The age distribution showed a peak frequency at 2-6 years of age (<2 years, 8.7%; 2-6 years, 60.8%; 7-10 years, 22.6%; 11-15 years, 8.0%). Typical respiratory organisms were identified in 64.9% of cases. Identified organisms were Mycoplasma pneumoniae (50.7%), bacteria in (5.9%), viruses (2.1%) and mixed infection (5.9%). Mycoplasma pneumoniae was the most commonly identified organism in all age groups. The majority (88.9%) of bacterial pneumonias including mixed infection were caused by Streptococcus pneumoniae. Mycoplasma pneumonia was the most frequent at 5-6 years of age, but bacterial pneumonia was most frequent at 1-2 years of age. Lobar/lobular pneumonia began to increase from August and showed peak incidence in November and December. The levels of WBC, ESR, and CRP more significantly elevated in those with bacterial pneumonia than in children with mycoplasma pneumonia. Pleural effusion was present in 18.1% of cases. In these cases, the duration of fever and hospitalization was prolonged, and the ESR and CRP levels were significantly higher, than those without pleural effusion. CONCLUSION: Mycoplasma pneumoniae was the most common organism causing lobar/lobular pneumonia in children. Mycoplasma pneumoniae was the most frequent causative organism at 5-6 years of age. On the other hand, bacterial pneumonia was more common at 1-2 years of age. Thus, age may be a significant factor for the diagnosis and treatment of lobar/lobular pneumonia in children.
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Enfant , Humains , Adenoviridae , Répartition par âge , Bactéries , Co-infection , Fièvre , Main , Hospitalisation , Incidence , Grippe humaine , Mycoplasma , Mycoplasma pneumoniae , Pharynx , Épanchement pleural , Pneumopathie infectieuse , Pneumopathie bactérienne , Pneumopathie à mycoplasmes , Études prospectives , Expectoration , Streptococcus pneumoniae , VirusRÉSUMÉ
Bronchioloalveolar carcinoma may present with a variety of clinical and radiographic findings. It is originated from the periphery of the lung and can be mistaken for lobar pneumonia or atypical pneumonia. The most frequent symptoms and signs are cough, sputum, shortness of breath, weight loss, hemoptysis, and fever. Brochorrhea is unusual and a late manifestation. We conclude that early diagnosis of disease will increase operability and improve chances of survival and that aggressive diagnostic workup for suspicious pulmonary infiltrate is essential as early operation offers the best chances of cure.We report two cases of brochioloalveolar carcinoma presenting as proper clinical and radiological findings.
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Adénocarcinome bronchioloalvéolaire , Toux , Dyspnée , Diagnostic précoce , Fièvre , Hémoptysie , Poumon , Pneumopathie infectieuse , Expectoration , Perte de poidsRÉSUMÉ
Objective To explore the clinical characteristics and diagnosis of mycoplasma pneumoniae(MP) pneumonia showing lobar pneumonia.Methods Patients from Jan.2004 to Dec.2005 were selected as researching case,which had samptoms and signs of respiratory in clinic,the chest Xray shown lobar pneumonia,the MP of down respiratory′s secretion detected by polymerase chain reaction(PCR) and MP-IgM of serum detected by indirect hemagglutination were positive.The clinical data of them were reviewed.Results MP pneumonia showing lobar pneumonia was same to streptococcus pneumoniae pneumonia in clinic,but it had some characters:1.majority of the lobar MP pneumonia were children being student;2.the process was long,the samptoms of respiratory was tipical,the continuous fever was few,and the infectious samptoms was not obvious as streptococcus pneumoniae pneumonia;3.the injury to lung was more and tipical;4.the increase of white blood cell,neutrocyte and C-reactive protein were not clearly as to streptococcus pneumoniae pneumonia,but the absorbing of lung′s focal was relatively fast;5.the ?-lactams antibiotic was not effective,but macrolides was effective.Conclusions Clinical characters of MP pneumonia are needed to master,the variety of chest X-ray changes and differentiate from other pneumonia infected by other are needed to notice.