肺炎支原体肺炎23S rRNA基因突变患儿的中医体质研究
作者：张 雪，张水堂
单位：广州中医药大学附属广东中西医结合医院，广东 佛山 528200
引用：引用：张雪，张水堂.肺炎支原体肺炎23S rRNA基因突变患儿的中医体质研究[J].中医药导报,2025,31(11):90-94,100.
DOI：10.13862/j.cn43-1446/r.2025.11.016
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摘要：
目的：探讨携带23S rRNA大环内酯类耐药基因的肺炎（MPP）支原体肺炎患儿的中医体质分布特征，分析其与临床表现、炎症指标及耐药基因突变的关联性。方法：选取2023年12月至2024年12月广东省中西医结合医院儿科住院部治疗的300例23S rRNA耐药基因突变的MPP患儿，依据中医体质分类标准进行体质辨识，收集患儿的临床资料、炎症指标及耐药基因突变信息，采用统计学方法分析患儿体质类型与临床特征及不同体质在临床耐药中的分布情况。结果：300例患儿中阴虚质[23.0%（69/300）]、湿热质[20.7%（62/300）]、痰湿质[16.0%（48/300）]为常见体质。湿热质与痰湿质患儿发热时间更长（P=0.000），高热发生率、湿啰音发生率显著高于其他体质P<0.05）；特禀质患儿喘息发生率最高（P<0.05）；痰湿质患儿胸腔积液发生率显著高于其他体质（P=0.003）。气郁质患儿肺实变发生率最高（P=0.035）；湿热质患儿住院时间、降钙素原水平显著高于平和质（P=0.001）；A2063G为最常见突变位点（52.7%），其LDH、PCT水平显著高于其他突变位点（P=0.018、P=0.025）。结论：不同体质患儿感染耐药基因的肺炎支原体菌株后临床表现不相同，提示体质类型可一定程度作为并发症预测的生物标志物。
关键词：肺炎支原体肺炎；体质辨识；耐药基因；儿童
Abstract：
Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Guangzhou University of Chinese Medicine, Foshan Guangdong 528200, China)
[Abstract] Objective: To investigate the distribution characteristics of Traditional Chinese Medicine (TCM) constitutions in children with mycoplasma pneumoniae pneumonia (MPP) carrying 23S rRNA macrolide resistance gene mutations, and to analyze their correlation with clinical manifestations, inflammatory markers, and resistance gene mutations. Methods: A total of 300 pediatric inpatients with MPP carrying 23S rRNA resistance gene mutations, treated in the Department of Pediatrics of Guangdong Hospital of Integrated Traditional Chinese and Western Medicine from December 2023 to December 2024, were selected. TCM constitution identification was performed according to the TCM constitution classification standard. Clinical data, inflammatory markers, and resistance gene mutation information were collected. Statistical methods were used to analyze the relationship between the children's constitution types and clinical features, as well as the distribution of different constitutions in clinical drug resistance. Results: Among the 300 children, Yin deficiency constitution [23.0%(69/300)], damp-heat constitution [20.7%(62/300)], and phlegm-dampness constitution [16.0% (48/300)] were the most common. Children with damp-heat or phlegm-dampness constitution had significantly longer fever duration (P=0.000), and the incidence of high fever and moist rales was significantly higher than that in other constitutions (P<0.05). Children with special diathesis constitution had the highest incidence of wheezing (P<0.05). The incidence of pleural effusion in children with phlegm-dampness constitution was significantly higher than that in other constitutions (P=0.003), while children with qi stagnation constitution had the highest incidence of pulmonary consolidation (P=0.035). Children with damp-heat constitution had significantly longer hospital stays and higher procalcitonin levels than those with balanced constitution (P=0.001). A2063G was the most common mutation site (52.7%), and its LDH and PCT levels were significantly higher than those of other mutation sites (P=0.018, P=0.025). Conclusion: Children with different TCM constitutions infected with macrolide-resistant mycoplasma pneumoniae strains present different clinical manifestations, suggesting that constitution type may serve as a potential biomarker for predicting complications to some extent.
Key words：mycoplasma pneumoniae pneumonia; constitution identification; drug-resistant genes; children
发布时间：2025-11-30
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