呼吸道感染患儿肺炎支原体感染流行特点和临床分析

Epidemiological and clinical analysis of Mycoplasma pneumoniae infection in children with acute respiratory tract infection

目的探讨小儿呼吸道感染者肺炎支原体(MP)感染的流行特点和临床情况。方法回顾性分析我院2004～2008年呼吸道感染住院患儿2084例,采用间接免疫荧光法检测MP,分析MP感染率与性别、年龄、季节、部位及与喘息性疾病的关系。结果2084例呼吸道感染患儿中MP阳性患儿433例(20.8%),其中男性222例(19.8%),女性211例(21.9%),男性与女性MP发病率无统计学差异(P>0.05)。不同年龄组MP发病率分别为:小于3岁组106例(15.0%),3～5岁组163例(25.2%),5～14岁组164例(22.5%),三组之间MP感染率差异有统计学意义(P<0.05)。不同季节MP感染率分别为:1～3月:18.0%,4～6月:25.1%,7～9月:17.7%,10～12月:20.5%,不同季节之间MP感染率统计学有显著性差异(χ2=12.5,P<0.05)。上、下呼吸道感染组MP感染率差异无统计学意义。在下呼吸道感染者中喘息组MP感染率(26.9%)高于非喘息组(20.2%)(P<0.05)。结论MP是小儿呼吸道感染的常见病原。MP感染与性别和感染部位无关,与年龄和季节有关,大于3岁患儿是易感人群,MP感染可能与喘息性呼吸道感染的发生有关。

Objective To summarize the epidemiology and clinical characteristics ofMycoplasrna pneurnoniae （MP） infection in children with acute respiratory tract infection （ARI） in Guangzhou. Methods MP was detected using an indirect immunofluorescent method in 2084 children with ARI. The relations between MP infection rate and the gender, age, season, site of infection and wheezing diseases were analyzed. Results A total of 433 children （20.8%） were positive for MP, including 222 boys （19.8%） and 211 girls （21.9%） without significant difference in the infection rate between the genders （P〉0.05）. In 0- to 3-year-old group, 106 children were positive for MP （15.0%）, while in 3- to 5-year-old group and 5- to 14-year-old group, 163 （25.2%） and 164 （22.5%） were positive, respectively, showing a significant difference in the infection rate between the 3 groups （P〈0.05）. The MP infection rate was 18.0% in January to March, 25.1% in April to June, 17.7% in July to September, and 20.5% in October to December, showing significant differences between the periods （P〈0.05）. No significant difference was found in the infection rate between children with acute upper respiratory tract infection （URI） and those with lower respiratory tract infection （LRI） （P〉0.05）. Among the children with LRI, those having wheezing disease had significantly higher MP positivity rate than those without wheezing. Conclusion MP is a common causative agent for ARI in children. MP infection is not related to gender and infection site, but to age and season. Children over 3 years old are vulnerable to MP infection. MP infection can be associated with wheezing in LRI.