秋冬当心肺炎支原体袭扰儿童_养生点睛- 舟山新闻网
秋冬当心肺炎支原体袭扰儿童 13:33:27来源：舟山新闻网
肺炎支原体是人类呼吸道感染的常见病原体之一，也是秋冬季呼吸道感染暴发流行的常见原因之一。肺炎支原体肺炎的发病高峰具有明显季节性差异，在我国的北方地区，每年的10月至来年2月为发病高峰时期，尤以11～12月发病率为高。此外，由于肺炎支原体肺炎与一般细菌、病毒所引起的肺炎相似，特别是从症状上难以鉴别，并且秋冬季节也是细菌、病毒所致肺炎的高峰季节，因此，人们应对那些不够典型的肺炎病例，以及常规治疗效果不佳的肺炎病例提高警惕，通过进一步的检查，争取做到早发现、早治疗、合理用。肺炎支原体肺炎的起病较为缓慢，常见于儿童及青少年病例，尤以7~14岁的儿童发病率为高。初期患者可有乏力、咽痛、纳差、肌痛等前驱症状，2～3天后出现头痛，咳嗽、咳痰及发热等典型症状。其咳嗽不如细菌性肺炎那样突出，多为阵发性、刺激性咳嗽，伴有少量粘痰或粘液脓性痰。患者一般无大量咳粘痰的临床表现，但有时咳嗽会逐渐加重，痰量也将随之增加。患者发热程度高低不一，多为中度发热，偶尔可高达39摄氏度左右。发热持续大约2～3周，咳嗽症状持续更长，直到发热退完之后仍有咳嗽。临床资料表明，患者除呼吸道受累之外，胸膜被累及的现象比较普遍，患者常有胸痛症状。另外，消化系统受累的情况也比较普遍，患者常有恶心、呕吐及腹泻症状。重症患者可有神经系统受累的症状如高热、脑膜刺激症、惊厥、偏瘫及精神行为异常等，还有少数患者具有心血管系统及泌尿系统受累的危险，心血管受累可并发心肌炎或心包炎，而肾脏受累则表现为血尿或蛋白尿。由此可见，秋冬季节若患者出现缓慢进展的下呼吸道感染征象，同时伴有其他系统受累改变时，就应虑及肺炎支原体肺炎。当患者下呼吸道症状明显，而体征并不明显时，务必要做胸部X线检查，患有肺炎支原体肺炎时其胸部X线具有两个特点，特点之一是X线表现与患者体征不一致，即X线表现严重但肺部体征轻微，甚至可无阳性体征可查。特点之二是病变多多单侧的肺下叶，呈现散在的斑片状阴影或毛玻璃样片状阴影。另外，实验室检查可对明确诊断有一定的帮助，肺炎支原体肺炎患者的血白细胞增高并不明显，但血沉和C-反应蛋白则明显增高，冷凝集试验通常呈现阳性改变。支原体肺炎的治疗措施包括抗支原体，对症处理及防治并发症。予以有针对性的抗生素杀灭肺炎支原体是减轻症状缩短病程及减少并发症的关键。当前，大环内酯类抗生素如红霉素、罗红霉素、阿奇霉素等是控制肺炎支原体感染的首选物，效果佳且不良反应少。虽然喹诺酮类抗生素如左氧氟沙星、加替沙星、莫昔沙星等也可用于肺炎支原体肺炎的治疗，但一般不作为首选，也不单独使用，而是与大环内酯类抗生素联合应用。/health/ys/3988.html
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