儿童肺炎支原体肺炎合并肺栓塞研究进展
Research Progress on Pediatric Mycoplasma pneumoniae Pneumonia Complicated with Pulmonary Embolism
DOI: 10.12677/acm.2026.1652166, PDF,   
作者: 刘瀚兮, 谢晓虹*:重庆医科大学附属儿童医院呼吸科,儿童发育疾病研究教育部重点实验室,国家儿童健康与疾病临床医学研究中心,儿童发育重大疾病国家国际科技合作基地,儿科学重庆市重点实验室,重庆
关键词: 儿童肺炎支原体肺栓赛Children Mycoplasma pneumoniae Pulmonary Embolism
摘要: 肺炎支原体是儿童社区获得性肺炎的常见病原体之一,其导致的临床症状表现各异。目前,关于肺炎支原体肺炎并发肺栓塞的报道虽不多见,然而一旦出现肺栓塞,疾病过程凶险,临床工作者需高度警惕,不断提高对该并发症的早期发现与处理水平。本文旨在对肺炎支原体肺炎合并肺栓塞领域的相关研究进展进行归纳与评述。
Abstract: Mycoplasma pneumoniae is one of the common pathogens responsible for community-acquired pneumonia in children. Its clinical manifestations are complex and diverse. Although reports of pulmonary embolism as a complication remain relatively rare, once thromboembolism occurs, the condition is often critical and life-threatening. Clinicians should therefore maintain a high index of suspicion and enhance their capacity for early recognition, diagnosis, and management. This article reviews the current research progress on Mycoplasma pneumoniae pneumonia complicated with pulmonary embolism.
文章引用:刘瀚兮, 谢晓虹. 儿童肺炎支原体肺炎合并肺栓塞研究进展[J]. 临床医学进展, 2026, 16(5): 3436-3443. https://doi.org/10.12677/acm.2026.1652166

参考文献

[1] Zhang, X., Sun, R., Hou, J., Jia, W., Li, P., Song, C., et al. (2024) Clinical Characteristics and Risk Factors of Pulmonary Embolism with Mycoplasma Pneumoniae Pneumonia in Children. Scientific Reports, 14, Article No. 24043. [Google Scholar] [CrossRef] [PubMed]
[2] 郑奎, 李曾妮, 韩周玻. 儿童重症肺炎支原体肺炎的发病机制及治疗研究进展[J]. 临床肺科杂志, 2025, 30(9): 1439-1443.
[3] Narita, M. (2016) Classification of Extrapulmonary Manifestations Due to Mycoplasma pneumoniae Infection on the Basis of Possible Pathogenesis. Frontiers in Microbiology, 7, Article 23. [Google Scholar] [CrossRef] [PubMed]
[4] Narita, M. (2010) Pathogenesis of Extrapulmonary Manifestations of Mycoplasma pneumoniae Infection with Special Reference to Pneumonia. Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy, 16, 162-169. [Google Scholar] [CrossRef
[5] Poddighe, D. (2018) Extra-Pulmonary Diseases Related to Mycoplasma Pneumoniae in Children: Recent Insights into the Pathogenesis. Current Opinion in Rheumatology, 30, 380-387. [Google Scholar] [CrossRef] [PubMed]
[6] 雷银兰. 8例儿童肺栓塞的临床分析[D]: [硕士学位论文]. 重庆: 重庆医科大学, 2020.
[7] 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 急性肺栓塞诊断和治疗指南2025 [J]. 中华心血管病杂志, 2025, 53(6): 587-619.
[8] 刘奉琴, 张晶, 陈星, 等. 儿童肺栓塞30例临床分析及病因探讨[J]. 中华实用儿科临床杂志, 2022, 37(18): 1386-1391.
[9] 孟晨, 吴福玲, 宁君, 等. 山东省肺炎支原体肺炎住院患儿横断面研究[J]. 中华实用儿科临床杂志, 2022, 37(16): 1245-1251.
[10] Biss, T.T., Brandão, L.R., Kahr, W.H., Chan, A.K. and Williams, S. (2008) Clinical Features and Outcome of Pulmonary Embolism in Children. British Journal of Haematology, 142, 808-818. [Google Scholar] [CrossRef] [PubMed]
[11] Raffini, L., Huang, Y.S., Witmer, C. and Feudtner, C. (2009) Dramatic Increase in Venous Thromboembolism in Children’s Hospitals in the United States from 2001 to 2007. Pediatrics, 124, 1001-1008. [Google Scholar] [CrossRef] [PubMed]
[12] Carpenter, S.L., Richardson, T. and Hall, M. (2018) Increasing Rate of Pulmonary Embolism Diagnosed in Hospitalized Children in the United States from 2001 to 2014. Blood Advances, 2, 1403-1408. [Google Scholar] [CrossRef] [PubMed]
[13] Liu, J., He, R., Wu, R., Wang, B., Xu, H., Zhang, Y., et al. (2020) Mycoplasma pneumoniae Pneumonia Associated Thrombosis at Beijing Children’s Hospital. BMC Infectious Diseases, 20, Article No. 51. [Google Scholar] [CrossRef] [PubMed]
[14] 董春娟, 宁静, 徐勇胜. 肺炎支原体肺炎患儿并发血管栓塞机制研究进展[J]. 山东医药, 2022, 62(8): 112-115.
[15] Margetic, S. (2012) Inflammation and Hemostasis. Biochemia Medica, 22, 49-62. [Google Scholar] [CrossRef
[16] Waites, K.B. and Talkington, D.F. (2004) Mycoplasma pneumoniaeand Its Role as a Human Pathogen. Clinical Microbiology Reviews, 17, 697-728. [Google Scholar] [CrossRef] [PubMed]
[17] Snowden, N., Wilson, P.B., Longson, M. and Pumphrey, R.S.H. (1990) Antiphospholipid Antibodies and Mycoplasma pneumoniae Infection. Postgraduate Medical Journal, 66, 356-362. [Google Scholar] [CrossRef] [PubMed]
[18] Saleem, S. and Berman, B. (2020) Deep Vein Thrombosis and Pulmonary Embolism in the Setting of Mycoplasma Infection. Case Reports in Medicine, 2020, Article 8708417.
[19] 宋绍秀, 徐勇胜. 儿童肺炎支原体肺炎合并肺栓塞9例临床分析并文献复习[J]. 山东大学学报(医学版), 2023, 61(11): 96-103.
[20] Liu, J. and Li, Y. (2021) Thrombosis Associated with Mycoplasma pneumoniae Infection (Review). Experimental and Therapeutic Medicine, 22, Article No. 967. [Google Scholar] [CrossRef] [PubMed]
[21] 田晓菲, 王晓冬, 申凯宁. 儿童肺炎支原体感染引起血栓栓塞的相关危险因素及治疗的研究进展[J]. 中国小儿急救医学, 2025, 32(11): 858-862.
[22] Tao, P., Wang, Z., Zhou, K. and Wu, Y. (2026) Pulmonary Embolism Complicating Mycoplasma pneumoniae Pneumonia in Children: A Retrospective Case Series. Frontiers in Pediatrics, 13, Article 1703027. [Google Scholar] [CrossRef
[23] Ying, Z., Li, Z., Li, J., Yang, F., Zhu, Z., Hu, G., et al. (2025) Quantitative Analysis of Pulmonary Vascular Alterations in Children with Refractory Mycoplasma pneumoniae Pneumonia. Quantitative Imaging in Medicine and Surgery, 15, 10409-10421. [Google Scholar] [CrossRef
[24] Fu, Y., Zhang, T.Q., Dong, C.J., Xu, Y.S., Dong, H.Q. and Ning, J. (2023) Clinical Characteristics of 14 Pediatric Mycoplasma pneumoniae Pneumonia Associated Thrombosis: A Retrospective Study. BMC Cardiovascular Disorders, 23, Article No. 1. [Google Scholar] [CrossRef] [PubMed]
[25] Sheng, C.Q., Yang, C.F., Ao, Y., et al. (2021) Mycoplasma pneumoniae Pneumonia with Pulmonary Embolism: A Study on Pediatric Cases in Jilin Province of China. Experimental and Therapeutic Medicine, 21, Article 201.
[26] Freund, Y., Cohen-Aubart, F. and Bloom, B. (2022) Acute Pulmonary Embolism: A Review. Journal of the American Medical Association, 328, 1336-1345. [Google Scholar] [CrossRef] [PubMed]
[27] Han, C., Zhang, T., Zheng, J., Jin, P., Zhang, Q., Guo, W., et al. (2022) Analysis of the Risk Factors and Clinical Features of Mycoplasma pneumoniae Pneumonia with Embolism in Children: A Retrospective Study. Italian Journal of Pediatrics, 48, Article No. 153. [Google Scholar] [CrossRef] [PubMed]
[28] Wang, C., Li, L., Xiao, G., Chen, Y., Wang, Y., Chen, Z., et al. (2024) Characteristics and Outcomes of Mycoplasma pneumoniae Pneumonia Associated with Pulmonary Embolism and Necrotizing Pneumonia in Children. Infection and Drug Resistance, 17, 1961-1969. [Google Scholar] [CrossRef] [PubMed]
[29] Ramiz, S. and Rajpurkar, M. (2018) Pulmonary Embolism in Children. Pediatric Clinics of North America, 65, 495-507. [Google Scholar] [CrossRef] [PubMed]
[30] Konstantinides, S.V., Meyer, G., Becattini, C., Bueno, H., Geersing, G., Harjola, V., et al. (2019) 2019 ESC Guidelines for the Diagnosis and Management of Acute Pulmonary Embolism Developed in Collaboration with the European Respiratory Society (ERS). European Heart Journal, 41, 543-603. [Google Scholar] [CrossRef] [PubMed]
[31] Maughan, B.C., Jarman, A.F., Redmond, A., Geersing, G. and Kline, J.A. (2024) Pulmonary Embolism. British Medical Journal, 384, e071662. [Google Scholar] [CrossRef] [PubMed]
[32] Freund, Y., Cohen-Aubart, F. and Bloom, B. (2022) Acute Pulmonary Embolism: A Review. Journal of the American Medical Association, 328, 1336-1345. [Google Scholar] [CrossRef] [PubMed]
[33] 谭珊珊, 曹玲. 低分子肝素辅助治疗D-二聚体升高的肺炎支原体肺炎患儿疗效[J]. 中华实用儿科临床杂志, 2018, 33(16): 1242-1245.
[34] Kanis, J., Hall, C.L., Pike, J. and Kline, J.A. (2018) Diagnostic Accuracy of the D-Dimer in Children. Archives of Disease in Childhood, 103, 832-834. [Google Scholar] [CrossRef] [PubMed]
[35] 范宇鸿, 李俊利, 苏学文. 儿童肺炎支原体肺炎合并肺动脉栓塞11例临床特征分析[J]. 中国临床新医学, 2025, 18(8): 854-858.
[36] 陈煜, 黄萍, 田维敏, 等. 难治性肺炎支原体肺炎并发血栓形成1例分析[J]. 临床儿科杂志, 2015, 33(2): 121-125.
[37] 罗志敏, 张先杰, 罗永彪, 等. D-二聚体测定在肺栓塞诊断中的应用价值[J]. 黑龙江医学, 2016, 40(4): 330-331.
[38] Hennelly, K.E., Baskin, M.N., Monuteuax, M.C., Hudgins, J., Kua, E., Commeree, A., et al. (2016) Detection of Pulmonary Embolism in High-Risk Children. The Journal of Pediatrics, 178, 214-218.e3. [Google Scholar] [CrossRef] [PubMed]
[39] Biss, T.T., Brandão, L.R., Kahr, W.H.A., Chan, A.K.C. and Williams, S. (2009) Clinical Probability Score and D-Dimer Estimation Lack Utility in the Diagnosis of Childhood Pulmonary Embolism. Journal of Thrombosis and Haemostasis, 7, 1633-1638. [Google Scholar] [CrossRef] [PubMed]
[40] De Monyé, W., Sanson, B.J., Mac Gillavry, M.R., Pattynama, P.M.T., Büller, H.R., Van Den Berg-Huysmans, A.A., et al. (2002) Embolus Location Affects the Sensitivity of a Rapid Quantitative d-Dimer Assay in the Diagnosis of Pulmonary Embolism. American Journal of Respiratory and Critical Care Medicine, 165, 345-348. [Google Scholar] [CrossRef] [PubMed]
[41] Snijders, D., Schoorl, M., Schoorl, M., Bartels, P.C., van der Werf, T.S. and Boersma, W.G. (2012) D-Dimer Levels in Assessing Severity and Clinical Outcome in Patients with Community-Acquired Pneumonia. A Secondary Analysis of a Randomised Clinical Trial. European Journal of Internal Medicine, 23, 436-441. [Google Scholar] [CrossRef] [PubMed]
[42] 杨利新, 王蓓, 徐保平, 等. 儿童肺炎支原体肺炎合并肺栓塞的临床和影像学表现[J]. 实用放射学杂志, 2020, 36(5): 784-787.
[43] 徐化凤, 杨雁, 张新荣, 等. 儿童肺炎支原体肺炎合并肺栓塞影像学表现及临床分析[J]. 实用放射学杂志, 2017, 33(10): 1588-1590.
[44] 单飞, 张志勇. 多排螺旋CT诊断肺栓塞进展[J]. 中国临床医学, 2005(5): 950-952.
[45] 王新房. 《超声心动图学》(第4版)出版[J]. 医学影像学杂志, 2009, 19(5): 579.
[46] 苏海燕, 金尾静, 张海邻, 等. 支原体肺炎合并肺栓塞一例临床分析[J]. 中华儿科杂志, 2012, 50(2): 151-154.
[47] Chilet, F., Iqbal, A.M., Mitzov, N., Eddib, A. and Muddassir, S. (2020) Acute Saddle Pulmonary Embolism: A Rare Complication of Mycoplasma pneumonia. Respiratory Medicine Case Reports, 30, Article 101033. [Google Scholar] [CrossRef] [PubMed]
[48] Hancock, H.S., Wang, M., Gist, K.M., Gibson, E., Miyamoto, S.D., Mourani, P.M., et al. (2013) Cardiac Findings and Long-Term Thromboembolic Outcomes Following Pulmonary Embolism in Children: A Combined Retrospective-Prospective Inception Cohort Study. Cardiology in the Young, 23, 344-352. [Google Scholar] [CrossRef] [PubMed]
[49] Başaran, A.E., Başaran, A., Durmuş, S.Y., Kazlı, T., Keven, A. and Bingöl, A. (2023) Analysis of Predictive Factors in Children with High Suspicion of Pulmonary Embolism. Pediatric Pulmonology, 59, 274-280. [Google Scholar] [CrossRef] [PubMed]
[50] Tiratrakoonseree, T., Charoenpichitnun, S., Natesirinilkul, R., Songthawee, N., Komvilaisak, P., Pongphitcha, P., et al. (2024) Clinical Prediction Tool to Identify Children at Risk of Pulmonary Embolism. Thrombosis Research, 234, 151-157. [Google Scholar] [CrossRef] [PubMed]
[51] Guan, Y., Zhao, B., Song, C., Hou, Q., Tong, T. and Xu, S. (2025) Development and Evaluation of a Nomogram for Predicting Pulmonary Embolism in Children with Severe Mycoplasma pneumoniae Pneumonia. Pediatric Pulmonology, 60, e71046. [Google Scholar] [CrossRef] [PubMed]
[52] Xie, L.N., Feng, T., Guo, Y.J., et al. (2024) Risk Factors for Embolism in Children with Refractory Mycoplasma pneumoniae Pneumonia and Construction of a Nomogram Model for Prediction of Embolism. Chinese Journal of Contemporary Pediatrics, 26, 486-492.
[53] Monagle, P., Cuello, C.A., Augustine, C., Bonduel, M., Brandão, L.R., Capman, T., et al. (2018) American Society of Hematology 2018 Guidelines for Management of Venous Thromboembolism: Treatment of Pediatric Venous Thromboembolism. Blood Advances, 2, 3292-3316. [Google Scholar] [CrossRef] [PubMed]
[54] Monagle, P., Chan, A.K.C., Goldenberg, N.A., et al. (2012) Antithrombotic Therapy in Neonates and Children: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 141, e737S-e801S.
[55] Navanandan, N., Stein, J. and Mistry, R.D. (2019) Pulmonary Embolism in Children. Pediatric Emergency Care, 35, 143-151. [Google Scholar] [CrossRef] [PubMed]
[56] 殷菊. 儿童肺栓塞与肺静脉血栓[J]. 中华实用儿科临床杂志, 2014, 29(15): 1131-1135.
[57] 中华人民共和国国家卫生健康委员会. 儿童肺炎支原体肺炎诊疗指南(2023年版) [J]. 国际流行病学传染病学杂志, 2023, 50(2): 79-85.
[58] 张飞州, 袁杰鑫, 陶孝芬, 等. 血栓性肺栓塞八例临床特征分析[J]. 中华儿科杂志, 2020, 58(1): 25-29.
[59] Cheng, R., Wang, Q., Jiang, L. and Liu, L. (2024) Pulmonary Thromboembolism Due to Mycoplasma pneumoniae in Children: A Case Report and Literature Review. BMC Pediatrics, 24, Article No. 816. [Google Scholar] [CrossRef] [PubMed]
[60] Obeng, E.A., Harney, K.M., Moniz, T., Arnold, A., Neufeld, E.J. and Trenor, C.C. (2015) Pediatric Heparin-Induced Thrombocytopenia: Prevalence, Thrombotic Risk, and Application of the 4ts Scoring System. The Journal of Pediatrics, 166, 144-150.e1. [Google Scholar] [CrossRef] [PubMed]
[61] Male, C., Lensing, A.W.A., Palumbo, J.S., et al. (2020) Rivaroxaban Compared with Standard Anticoagulants for the Treatment of Acute Venous Thromboembolism in Children: A Randomised, Controlled, Phase 3 Trial. The Lancet Haematology, 7, e18-e27.
[62] 孙雨茁, 罗平. 利伐沙班在儿童血栓栓塞性疾病的应用研究进展[J]. 中华实用儿科临床杂志, 2022, 37(9): 710-713.
[63] Taha, M.A., Busuttil, A., Bootun, R. and Davies, A.H. (2019) A Systematic Review of Paediatric Deep Venous Thrombolysis. Phlebology: The Journal of Venous Disease, 34, 179-190. [Google Scholar] [CrossRef] [PubMed]
[64] Song, S. and Xu, Y. (2023) A Retrospective Study of the Clinical Characteristics of 9 Children with Pulmonary Embolism Associated with Mycoplasma pneumoniae Pneumonia. BMC Pediatrics, 23, Article No. 370. [Google Scholar] [CrossRef] [PubMed]
[65] Akam-Venkata, J., Forbes, T.J., Schreiber, T., Kaki, A., Elder, M., Turner, D.R., et al. (2019) Catheter-Directed Therapy for Acute Pulmonary Embolism in Children. Cardiology in the Young, 29, 263-269. [Google Scholar] [CrossRef] [PubMed]
[66] Morgan, R.W., Stinson, H.R., Wolfe, H., Lindell, R.B., Topjian, A.A., Nadkarni, V.M., et al. (2018) Pediatric In-Hospital Cardiac Arrest Secondary to Acute Pulmonary Embolism. Critical Care Medicine, 46, e229-e234. [Google Scholar] [CrossRef] [PubMed]
[67] Ross, C.E., Shih, J.A., Kleinman, M.E. and Donnino, M.W. (2020) Pediatric Massive and Submassive Pulmonary Embolism: A Single-Center Experience. Hospital Pediatrics, 10, 272-276. [Google Scholar] [CrossRef] [PubMed]
[68] Baird, J.S., Killinger, J.S., Kalkbrenner, K.J., Bye, M.R. and Schleien, C.L. (2010) Massive Pulmonary Embolism in Children. The Journal of Pediatrics, 156, 148-151. [Google Scholar] [CrossRef] [PubMed]
[69] Fukuda, A., Isoda, T., Sakamoto, N., Nakajima, K. and Ohta, T. (2019) Lessons from a Patient with Cardiac Arrest Due to Massive Pulmonary Embolism as the Initial Presentation of Wilms Tumor: A Case Report and Literature Review. BMC Pediatrics, 19, Article No. 39. [Google Scholar] [CrossRef] [PubMed]
[70] Ting, M., Rodriguez, M., Gowda, S.T., Anders, M., Qureshi, A.M. and Grimes, A. (2019) Cardiovascular Recurrence of High-Grade Osteosarcoma Presenting as Atrial Thrombosis and Pulmonary Embolism: A Case Report and Review of the Pediatric Literature. Pediatric Hematology and Oncology, 36, 244-251. [Google Scholar] [CrossRef] [PubMed]
[71] Bastas, D., Brandão, L.R., Vincelli, J., Wilson, D., Perrem, L., Guerra, V., et al. (2024) Long-Term Outcomes of Pulmonary Embolism in Children and Adolescents. Blood, 143, 631-640. [Google Scholar] [CrossRef] [PubMed]
[72] 中国医药教育协会儿科专业委员会, 中华医学会儿科学分会呼吸学组, 中国医师协会呼吸医师分会儿科呼吸工作委员会, 等. 儿童肺血栓栓塞症诊断与治疗专家共识[J]. 中华实用儿科临床杂志, 2025, 40(2): 81-91.
[73] Bashir, D.A., Cargill, J.C., Gowda, S., Musick, M., Coleman, R., Chartan, C.A., et al. (2024) Implementing a Pediatric Pulmonary Embolism Response Team Model: An Institutional Experience. Chest, 165, 192-201. [Google Scholar] [CrossRef] [PubMed]