探讨肺炎衣原体(CP)感染导致儿童肺炎衣原体肺炎(CPP)患儿的临床特征。

选择2023年7月至2025年4月苏州大学附属儿童医院收治的174例CPP患儿为研究对象。根据是否单纯CP感染，将其分为A组(n＝96，单纯CP感染患儿)和B组(n＝78，CP＋其他病原体感染患儿)；再根据CP感染与混合感染病原体种类将B组患儿进一步分为B1亚组(n＝40，CP＋混合病毒＋MP感染者)，B2亚组(n＝25，CP＋混合细菌感染者)及B3亚组(n＝13，CP＋混合病毒＋MP＋细菌感染者)。采用回顾性分析方法，比较A组和B组，以及3个亚组CPP患儿临床表现、实验室检查结果、影像学特征。本研究遵循的程序符合苏州大学附属儿童医院医学伦理委员会制定的标准，并获得该伦理委员会批准(审批号：2025CS134)，并与患儿监护人签署知情同意书。

①这174例CPP患儿中，单纯CP感染为96例(55.2%)，混合感染为78例(44.8%)；以男性(64.9%，113/174)和>6岁(90.8%，158/174)患儿为主，平均病程为14 d。所有CPP患儿均有咳嗽症状，76例(43.7%)发热，138例(79.3%)咳痰。混合感染CPP患儿中，鼻病毒(HRV)检出率最高(27/78，34.6%)，其次为金黄色葡萄球菌(12/78，15.4%)。②A组患儿喘息发生率显著低于B1亚组，并且差异有统计学意义(P<0.05)。A组患儿中等热发生率显著高于B2亚组，但是高热发生率显著低于B2亚组，差异均有统计学意义(P<0.05)。A组患儿呕吐发生率显著低于B3亚组，差异亦有统计学意义(P<0.05)。③A组分别与B1亚组、B2亚组、B3亚组CCP患儿的外周血白细胞计数(WBC)、中性粒细胞百分比(NEUT%)、超敏C反应蛋白(hs-CRP)、α-羟丁酸脱氢酶(α-HBDH)、丙氨酸转移酶(ALT)及肌酸激酶同工酶MB(CK-MB)水平等比较，差异均无统计学意义(P>0.05)。④影像学检查结果显示，这174例CPP患儿中，单肺受累占比较多(71.8%，125/174)，右肺下叶为最常见受累部位(19.5%，34/174)。

儿童CPP混合感染发生率高，年龄越小越易合并感染，临床症状更重，对于CPP患儿应积极行病原学检测，及时对其采取针对性干预措施。

To analyze the clinical features of Chlamydia pneumoniae pneumonia in children (CPP).

A total of 174 children with CPP admitted to the Suzhou University Affiliated Children′s Hospital from July 2023 to April 2025 were selected as research subjects. Based on the type of infection, they were divided into two groups, group A (n=96) and group B (n=78). The group B was further categorized into three subgroups according to the types of pathogens: subgroup B1 (n=40, mixed viral/mycoplasma pneumoniae infections), subgroup B2 (n=25, mixed bacterial infections), and subgroup B3 (n=13, mixed viral/mycoplasma pneumoniae and bacterial infections). The clinical manifestations, laboratory test results, and imaging characteristics were compared retrospectively. The study followed the standards set by the Medical Ethics Committee of the Suzhou University Affiliated Children′s Hospital and got the committee′s approval (Approval No. 2025CS134), and informed consent from the children′s guardians were obtained.

①Among 174 children with CPP, 96 cases (55.2%) had isolated CP infection, while 78 cases (44.8%) had mixed infections; the majority were male (64.9%, 113/174) and over 6 years old (90.8%, 158/174), averaging 14 days of illness. All children had cough symptoms, 76 cases (43.7%) had fever, and 138 cases (79.3%) had sputum production. Among children with mixed infections, rhinovirus (HRV) had the highest detection rate (27/78, 34.6%), followed by Staphylococcus aureus (12/78, 15.4%). ②The incidence of wheezing in group A was significantly lower than that in subgroup B1, with the difference reaching statistical significance (P<0.05). In group A, the incidence of moderate fever was significantly higher, whereas the incidence of high fever was significantly lower than that in subgroup B2, and both differences were statistically significant (P<0.05). In addition, the incidence of vomiting in group A was significantly lower than that in subgroup B3, and the difference was also statistically significant (P<0.05). ③Comparisons of white blood cell count (WBC), neutrophil percentage (NEUT%), hs-CRP, alpha-hydroxybutyrate dehydrogenase(α-HBDH), alanine aminotransferase (ALT), and creatine kinase-MB isoenzyme (CK-MB) levels between group A and groups B1, B2, and B3 showed no significant differences (P>0.05). ④Imaging examination results showed that unilateral lung involvement was more common (71.8%, 125/174), with the right lower lobe being the most commonly affected area (19.5%, 34/174), and lesions involving ≥2 lung lobes were observed in 74 cases (42.5%).

The incidence of mixed infections in children with CPP is high. The younger they are, the more likely they are to have mixed infections, which come with more severe symptoms. For children with CPP, we should actively test for pathogens to quickly identify mixed infections and offer targeted treatments.