肺炎支原体IgM抗体阳性肺结核患者的流行病学特征

Epidemiological characteristics of Mycoplasma pneumoniae IgM antibody positive in pulmonary tuberculosis patients

目的:探讨肺结核患者肺炎支原体(MP),IgM抗体流行病学特征,为防治支原体感染提供科学依据。方法:选取本院2018年1-12月收治的肺结核确诊患者为研究对象,入院后空腹采血,采用间接免疫荧光法检测血清MP-IgM抗体,使用SPSS20.0统计学软件对所有患者的临床资料及MP-IgM抗体阳性率进行比较分析。结果:1551例肺结核患者中,血清MP-IgM抗体阳性178例,阳性率为11.48%。全年血清MP-IgM抗体阳性率随着气候变化而不同,4个季度阳性率比较,总体差异有统计学意义(X^(2)=13.86,P<0.05)。季度间比较,春季,(13.52%)和冬季(14.97%)MP-IgM检测阳性率均高于夏季(7.93%)。其余各季度间比较,差异无统计意义。多因素二分类logistic回归分析结果显示,性别为男性、利福平耐药在肺结核并发MP感染患者中的比率更低[OR值(95%CI值)分别为0.54(0.39~0.76)、0.60(0.38~0.97)]。结论:本地区肺结核患者,并发MP感染占有一定比例,春季和冬季的感染率高于夏季,女性、利福平敏感的患者更容易感染MP。临床应重视肺结核患者合并MP感染。

Objective:To investigate the epidemiological characteristics of Mycoplasma pneumoniae IgM antibody(MP-IgM)in pulmonary tuberculosis(PTB)patients,and to provide a scientific basis for clinical prevention and treatment of MP infection.Methods:PTB patients who were admitted to our hospital from January to December 2018 were selected as the research subjects.Fasting blood samples were collected at admission and MP-IgM in serum was detected by indirect immunofluorescence assay.Clinical data and the positive rate of MP-IgM in all patients were compared and analyzed by SPSS20.0 statistical software.Results:Among 1551 PTB patients,178 patients were positive for MP-IgM in serum,and the positive rate was 11.48%.The positive rates of MP-IgM in serum varied with climate change throughout the year,and the difference was statistically significant during the four seasons(X^(2)=13.86,P<0.05).The positive rates of MP-IgM in spring(13.52%)and winter(14.97%)were higher than that in summer(7.93%).There was no statistically significant difference between other quarters.Multivariate binary logistic regression analysis showed that the probability of male and rifampicin resistance was lower in tuberculosis patients complicated with MP infection[OR(95%CI)were 0.54(0.39~0.76)and 0.60(0.38-0.97)]respectivelyl.Conclusion:A certain proportion of PTB patients were complicated by MP infection in this area.The rates of MP infection in spring and winter are higher than that in summer.Women and patients with rifampicin sensitivity are more likely to be infected by MP.More clinical attention should be paid to PTB patients complicated with MP infection.