儿童肺炎支原体肺炎早期诊断及治疗研究进展

Research progress on early diagnosis and treatment of Mycoplasma pneumoniae pneumonia in children

摘要

肺炎支原体肺炎（MPP）是儿童社区获得性肺炎的常见类型, 其发病率上升、重症化趋势显著, 大环内酯类耐药问题突出, 早期精准诊断与规范化治疗是改善MPP预后的核心。儿童MPP早期诊断存在症状不特异、血清学检测有时间窗、分子检测难以区分感染与定植、影像学检查缺乏特异性表现等难点。文章紧扣早期诊断主线, 明确区分肺炎支原体感染与MPP、病原检测与临床诊断, 系统梳理临床早期识别要点、实验室检测、影像学技术及人工智能辅助诊断的价值与局限, 构建“临床筛选-快速病原检测-影像学支持”整合诊断框架；结合耐药现状阐述西医分层治疗、免疫调节治疗, 并融入中医“肺炎喘嗽”辨证施治思路, 突出中西医结合协同增效优势, 为儿童MPP早期精准诊疗、降低重症与后遗症风险提供参考。

Abstract

Mycoplasma pneumoniae pneumonia (MPP) is a common type of community-acquired pneumonia in children. Its incidence is rising with an obvious severe tendency, and macrolide resistance has become a prominent clinical problem. Early precision diagnosis and standardized treatment are the key to improving prognosis. There are several difficulties in early diagnosis of pediatric MPP, including non-specific early symptoms, time window of serological detection, inability of molecular detection to distinguish infection from colonization, and non-specific imaging manifestations. Focusing on the main line of early diagnosis, the paper clearly distinguishes between Mycoplasma pneumoniae (MP) infection and MPP, and pathogen detection and clinical diagnosis, systematically reviews the value and limitations of early clinical identification, laboratory detection, imaging technology and artificial intelligence-assisted diagnosis, and constructs an integrated diagnosis framework of "clinical screening-rapid pathogen detection-imaging support". Taking the current situation of drug resistance into account, the paper expounds the hierarchical treatment of Western medicine and immunomodulatory therapy, integrating the syndrome differentiation of traditional Chinese medicine for "pneumonia with dyspneic cough" and highlighting the synergistic effect of integrated traditional Chinese and Western medicine. It provides a reference for early precision diagnosis and treatment of pediatric MPP and reducing the risk of severe illness and sequelae.

关键词

肺炎支原体肺炎 / 早期诊断 / 耐药性 / 儿童

Key words

Mycoplasma pneumoniae pneumonia / Early diagnosis / Drug resistance / Child

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基金资助

内蒙古自治区自然科学基金项目(2026MS0146)

内蒙古自治区自然科学基金项目(2023MS08031)

国家卫生健康委能力建设和继续教育中心（国家卫生健康委党校）2025年度慢病管理研究项目(GWJJMB202510021152)