宝鸡地区小儿急性下呼吸道感染病毒和肺炎支原体病原学的多中心研究分析

Multi-center research and analysis of children with acute of lower respiratory tract infection and pneumonia,mycoplasma etiology in Baoji

【目的】了解病毒和肺炎支原体病原在宝鸡地区小儿急性下呼吸道感染(acute lower respiratory infec-tions,ALRI)患儿中的构成特点。【方法】收集宝鸡市5家医院2010年8月-2011年7月ALRI住院小儿7 979例的病毒和肺炎支原体病原学检测结果进行汇总分析。【结果】小儿ALRI患儿血清7种急性病毒抗体IgM总阳性率为32.7%;阳性率由高到低依次为:EB病毒抗衣壳抗原抗体IgM 7.6%,柯萨奇病毒抗体IgM 7.2%,巨细胞病毒抗体IgM5.5%,埃可病毒抗体IgM 5.1%,副流感病毒抗体IgM 4.1%,腺病毒抗体IgM 2%,呼吸道合胞病毒抗体IgM 1.2%。肺炎支原体抗体IgM阳性率12.6%。下呼吸道分泌物病原核酸(PCR-荧光探针法)检测阳性率结果为:EB病毒DNA24.4%,肠道病毒(普通型)RNA 10.7%,呼吸道合胞病毒RNA 4.3%,柯萨奇病毒A 16 3.8%;肺炎支原体核酸定量阳性率为11.7%。临床最常见的混合感染是EBV和MP混合感染。【结论】小儿ALRI病原学分布存在人群、地区和季节、年份等的差异性,病毒和肺炎支原体是宝鸡地区小儿ALRI的重要病原,病毒以EBV为主。应开展多方法、多病原的联合检测。

[Objective] To understand of the compositional characteristics the pathogenic virus and Mycoplasma pneumoniae in acute lower respiratory infections （ALRI） children in Baoji. [Method] From five hospitals in Baoji City, August 2010-July 2011,7 979 cases of ALRI were collected in children hospitalized with virus and Mycoplasma pneumoni ae pathogen test results for meta-analysis. [Results] The 7 kinds of serum acute virus IgM antibody positive rate was 32.7 % in ALRI children;The positive rate were：EB virus capsid antigen antibody anti-IgM 7.6 %, coxsackie virus antibody IgM 7.2% ,CMV antibody IgM 5.5 %, echovirus antibody IgM 5. 1%, parainfluenza virus antibody IgM 4.1%, adenovirus antibody IgM 2%, respiratory syncytial virus antibody IgM 1. 2V00, mycoplasma pneumoniae antibody IgM positive rate 12.6 %. The pathogenic nucleic acid （PCR-fluorescent probe） positive rate of lower respiratory tract secretions were..EB vi- rus DNA 24.4% ,enteric virus（ordinary type） RNA 10. 7%, RSV RNA 4. 3%, Coxsackie virus A16 3.8% ; Mycoplasma pneumoniae nucleic acid quantitation positive rate was 11. 7%. The most common clinical EBV mixed infection was with MP. [Conclusions] The etiology of ALRI in children shows differences in the distribution of population,area and season, year,etc. EBV and Mycoplasma pneumoniae in children with ALRI in Baoji were important pathogen. Multi-method, multijoint detection of pathogens should he carried out.