Clinical characteristics of Mycoplasma pneumoniae pneumonia in children of different ages / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the clinical,laboratory and imaging characteristics of children with Mycoplasma pneumoniae pneumonia (MPP) in different age groups.Methods One hundred and sixty-four children whose ages were 1 month to 14 years old with MPP hospitalized at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine in 2017 were enrolled as study objects.All children were classified into 2 groups1 month to 3 year-old group (46 cases) and ＞ 3 to 14 year-old group (118 cases).The clinical features,main laboratory and imaging findings of 2 groups were retrospectively analyzed and compared.Results (1) Compared with 1 month to 3 year-old group,＞ 3 to 14 year-old group had more patients with fever [97.5％ (115/118 cases) vs.84.8％ (39/46 cases)],longer duration of fever [48.3％ (57/118 cases) vs.23.9％ (11/46 cases)] and higher fever [83.1％ (98/ 118 cases) vs.52.2％ (24/46 cases)],but less patients with wheezing [2.5％ (3/118 cases) vs.43.5％ (20/46 cases)],shortness of breath and dyspnea [0.8％ (1/118 cases) vs.15.2％ (7/46 cases)],dry rale [1.7％ (2/118 cases) vs.60.9％ (28/46 cases)] and wet pulmonary rale [50.0％ (59/118 cases) vs.69.6％ (32/46 cases)],and the differences were statistically significant (all P ＜ 0.05).(2) The increase of platelet count,creatine kinase isoenzyme (CK-MB) and lactate dehydrogenase (LDH) in 1 month to 3 year-old group of MPP [316.0 (229.3,372.3) × 109/L,25.70 (17.70,31.98) U/L,346.5 (310.3,388.3) U/L] were more common than those in ＞ 3 to 14 year-old group [266.0 (205.8,317.8) × 109/L,21.50 (15.75,28.00) U/L,303.0 (173.0,352.0) U/L],while the increase of C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in ＞ 3 to 14 year-old group [12.66(9.16,19.44) mg/L,23.00(17.75,29.00) mm/1 h] were more common than those in 1 month to 3 year-old group[2.46 (0.54,11.63) mg/L,14.00 (10.00,20.25) mm/1 h],and there were significant statistical differences (all P ＜ 0.05).(3) The MPP imaging features of children in different age groups were diverse.In 1 month to 3 year-old group,the double lung involvement [80.4％ (37/46 cases)] was more obvious than that in ＞3 to 14 year-old group [55.9％ (66/118 cases)],and the difference was statistically significant (P ＜ 0.05).The lesions of 1 month to 3 year-old group were more common in lobular pulmonary [82.6％ (38/46 cases)],while in ＞ 3 to 14 year-old group,the radiographic findings were predominant with consolidation in the segment or lobe of the lung [33.1％ (39/118 cases)],and the difference was statistically significant (P ＜ 0.01).Conclusions Younger than 3 year-old children with MPP are prone to wheezing,shortness of breath,dyspnea and lung rale,while the rise of CK-MB and LDH is common.Imaging is mainly involved in double lung involvement and pulmonary lobule infiltration.The older the children with MPP are,the longer the fever duration is,and more common is the higher fever.The older the children,the more more easily they have the relative increase of CRP and ESR,and at the same time they are more likely to have the consolidation of the lung segment or lobe.