儿童肺炎支原体坏死性肺炎的早期识别与 诊疗进展
Early Identification and Diagnosis and Treatment Progress of Mycoplasma pneumoniae Necrotizing Pneumonia in Children
DOI: 10.12677/acm.2026.1641547, PDF,   
作者: 谢 霞：重庆医科大学附属儿童医院呼吸科，儿童少年健康与疾病国家临床医学研究中心，儿童发育疾病研究教育部重点实验室，重庆；罗征秀*：重庆医科大学附属儿童医院呼吸科，儿童少年健康与疾病国家临床医学研究中心，儿童发育疾病研究教育部重点实验室，重庆；儿童感染与免疫罕见病重庆市重点实验室，重庆
关键词: 儿童；肺炎支原体肺炎；坏死性肺炎；早期识别；预测模型；诊疗策略；Children； Mycoplasma pneumoniae Pneumonia； Necrotizing Pneumonia； Early Identification； Predictive Model； Management Strategy
摘要: 肺炎支原体坏死性肺炎(MPNP)是儿童肺炎支原体肺炎(MPP)的严重并发症，以肺实质坏死、液化及空腔形成为主，预后较差。其早期临床表现与普通MPP高度重叠，坏死征象在影像学上出现较晚，易延误诊断。本文综述了MPNP的发病机制、临床与实验室特征、影像学演变规律、早期识别指标及预测模型研究进展，并讨论了抗感染、免疫调节、呼吸介入等综合诊疗策略进展。强调通过持续高热、炎症/凝血指标异常及影像进展等线索进行早期风险分层，及时行增强CT评估，以实现早期干预、改善预后。
Abstract: Mycoplasma pneumoniae necrotizing pneumonia (MPNP) is a severe complication of Mycoplasma pneumoniae pneumonia (MPP) in children, characterized by parenchymal necrosis, liquefaction, and cavity formation, associated with poor prognosis. Early clinical manifestations overlap significantly with typical MPP, while necrotic features appear late on imaging, leading to diagnostic delays. This review summarizes the pathogenesis of MPNP, clinical and laboratory features, imaging evolution, early identification markers and predictive models, as well as comprehensive management strategies involving anti-infective therapy, immunomodulation, interventional procedures, and complication management. Emphasis is placed on early risk stratification through persistent fever, abnormal inflammatory/coagulation markers, and imaging progression, with timely contrast-enhanced CT to facilitate early intervention and improve outcomes.
文章引用：谢霞, 罗征秀. 儿童肺炎支原体坏死性肺炎的早期识别与 诊疗进展[J]. 临床医学进展, 2026, 16(4): 2903-2913. https://doi.org/10.12677/acm.2026.1641547

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