5岁以下儿童反复喘息发作呼吸道病原分析

Analysis of respiratory infection pathogens in children under 5 years old with recurrent wheezing

目的探讨5岁以下儿童反复喘息发作与呼吸道感染之间的关系。方法 2014年1月1日至2014年12月31日在我科住院治疗的525例5岁以下反复喘息儿童按年龄分三组:A组30天-1岁,B组1-3岁,C组3-5岁。收集急性喘息发作期血清,采用间接免疫荧光法同时检测:腺病毒(ADV)、呼吸道合胞病毒(RSV)、甲型流感病毒(IAV)、乙型流感病毒(IBV)、副流感病毒(PIVs)、嗜肺军团菌Ⅰ型(LP1)、肺炎支原体(MP)、Q热立克次体(COX)、肺炎衣原体(CP)9种呼吸道病原体Ig M抗体。结果呼吸道病原体Ig M检测阳性者233例(阳性率44.38%);MP检测阳性率最高,达24.38%;其次是ADV和RSV,阳性率分别为10.10%和9.90%。不同年龄组喘息儿童病原体检测种类亦不相同。A组以RSV检测阳性率最高,达18.10%,显著高于其他组患儿(P<0.01);B组和C组患儿以MP检测阳性率最高,分别为31.15%和25.22%,高于A组(P<0.05)。结论儿童喘息反复发作主要与呼吸道感染有关,MP、ADV和RSV是本地区引起5岁以下儿童喘息发作的主要病原体。

Objective To explore the association of respiratory infections with recurrent wheezing in children under 5 years old. Methods 525 hospitalized recurrent wheezing children less than 5 years old from Jan 2014 to Dec 2014 were collected and divided into the group A （30 days old）, the group B （1-3 years old） and the group C （3-5 years old）. Indirect immunofluorescence assay was used to detect IgM antibodies against 9 types of respiratory pathogens, including Adenovirus （ ADV）, Respiratory syncytial virus （ RSV）, Influenza A （ INFA）, Influenza B （INFB）, Parainfluenza 1, 2 and 3 （PIVs）, Legionella pneumophila serogroup 1 （LP1）, Mycoplasma pneumonia （MP）, Coxiella bumetii （COX）, and Chamydophila pneumonia （CP）. Results There were 233 positive cases （44. 38% ）. MP was the dominant pathogen with the highest positive rate of 24. 38%, followed by ADV and RSV （ 10. 10% and 9. 90% respectively）. The types of pathogens were different in the three groups. The positive rate of RSV was 18. 10% in the group A, which was significant higher than that in the other groups （P 〈0. 01 ）. The posi- tive rate of MP in the group B and C （31.15% and 25.22% respectively） was significant higher than that in the group A （ P 〈 0. 05 ）. Conclusion Respiratory tract infections are closely associated with recurrent wheezing in chil- dren age younger than 5 years old, which the main causes are MP, ADV and RSV.