深圳儿童急性下呼吸道感染病原学监测

Etiology monitoring in the children suffer from acute lower respiratory tract infection in Shenzhen.

【目的】监测两年深圳地区儿童急性下呼吸道感染的病毒等病原分布情况及临床流行特点。【方法】2003年12月～2005年11月该地区确诊为急性下呼吸道感染的5651例患儿，取静脉血用ELISA法同时检测5种呼道病毒及肺炎支原体、肺炎衣原体的特异性IgM。【结果】病原检测阳性者2884例，总阳性率51．0％，其中混合染1061例，占18．8％，各病毒病原的检出率依次为流感病毒B（IFVB）927例（16．4%），腺病毒（ADV）291例（5．1％），呼吸道合胞病毒（RSV）253例（4．5％），副流感病毒（PIV）241例（4．3％），流感病毒A（IFVA）19例（0．3％）；肺炎支原（MP）2440例（43．2％），肺炎衣原体（CP）33例（O．6％）。所有受检者中MP阳性者最多，达43．2％，3岁以上年龄段高67．7％。2004年10月～2005年9月出现MP流行高峰，MP阳性者占受检者的40％以上胸片上表现为大叶性或节段肺炎141例。毛细支气管炎中RSV的检出率7．6％。【结论】肺炎支原体可能是近年来深圳地区儿童急性下呼吸感染的最常见病原，2004～2005年在深圳市儿童中出现一次流行，临床表现多样；病毒以IFVB最为多见，流行不明显，每年高温季节（5～8月）检出率较高。

[Objective] To monitor the epidemiologic and clinical feature of acute lower respiratory tract infection （ALRI） in children in Shenzhen for 2 years. [Method] From December 2003 to November 2005, the method of ELISA was used to test the special IgM of virus,MP,CP in serum in 5 651 children with ALRI. [Results] The pathogens were demonstrated in 2 884 children as the positive （51.0 % ）, including 496 cases（18.8 % ） with the mixed infection, IFVB 927 （16.4%）,ADV 291（5.1%）, RSV 253（4.5%）,PIV 241（4.3%）,IFVA 19（0.3%）; MP 2 440（43.2%）,CP 33（0.6%）. The positive rate of MP was the highest, it was 67.7% in the children who were above 3 years of age. There was a prevalence peak of MP from october 2004 to september 2005. The chest X-ray of 141 patients were lobar or segmental pneumonia. The positive rate of RSV was only 7.6% in the children with bronchiolitis. [Conclusions] MP is probably a main etiological agent of ALRI in children in Shenzhen, and there was a prevalence peak from 2004 to 2005. The clinical manifestation of MP infection is diversified. Among the 5 virus, IFVB is the most predominant one, and the detection rate has a increased trend in the hot season.