泸州地区冬春季儿童呼吸道感染病原体研究

Study on pathogens of children respiratory tract infection during winter-spring seasons in Luzhou area

目的了解泸州地区冬春季儿童呼吸道感染的病原体特点,为临床诊治提供参考依据。方法采集2011年11月至2012年5月于泸州医学院附属医院儿科住院的1 170例呼吸道感染患儿的血清标本,使用间接免疫荧光法检测嗜肺军团菌(LP1)、肺炎支原体(MP)、Q热立克次体(COX)、肺炎衣原体(CP)、腺病毒(ADV)、呼吸道合胞病毒(RSV)、甲型流感病毒(IV-A)、乙型流感病毒(IV-B)、副流感病毒(PIV)9种病原体血清免疫球蛋白M(IgM)抗体。结果从1 170例患儿血清标本中检测出阳性标本676例,阳性率为57.78%,以MP阳性率最高,其次为LP1、IV-B、PIV、IV-A、ADV、RSV、COX、CP;混合感染458例,阳性率为39.15%,主要为两种病原体混合感染。各年龄段间以小于1岁组阳性率最低,为27.36%,最高为>3～6岁组,占89.72%,各组间比较,差异有统计学意义(P<0.05);不同性别间患儿呼吸道病原体阳性率比较,差异无统计学意义(χ2=3.47,P>0.05)。结论 MP、LP1和IV-B是泸州地区冬春季儿童呼吸道感染的主要病原体,混合感染仍是该地区发病一大特点;病原体感染在各年龄组间存在差异,而不同性别间比较,差异无统计学意义(P>0.05)。

Objective To understand the characteristics of pathogens in children respiratory tract infection during winter-spring seasons in Luzhou area and to provide some evidence for clinical diagnosis and treatment.Methods 1 170 serum samples were collected from the hospitalized children with respiratory tract infection in this hospital from November 2011 to May 2012.Indirect immunofluorescence assay was applied to detect IgM antibodies of 9 pathogens,including legionella pneumophila（LP1）,mycoplasma pneumoniae（MP）,Q fever rickettsial（COX）,Chlamydia pneumoniae（CP）,adenovirus（ADV）,respiratory syncytial virus（RSV）,influenza A virus（IV-A）,Influenza B virus（IV-B） and Parainfluenza virus（PIV）.Results Totally 676 cases of positive samples were detected with the positive rate of 57.78%.Among 9 pathogens,the positive rate of MP was highest,followed by LP1,IV-B,PIV,IV-A,ADV,RSV,COX and CP.458 cases（39.15%） were mixed infection,which were mainly infected by two pathogens.Among various age groups,the positive rate of age﹤1 years old was lowest（27.36%）,while the 3-6-year-old group was highest（89.72%）,which had statistically significant difference among various age groups（P〈0.05）.The positive rate of the pathogens between genders had no statistically significant difference（χ^2=3.47,P〉0.05）.Conclusion MP,LP1 and IV-B are the main pathogens in children respiratory tract infection during winter-spring seasons in Luzhou area.The mixed infection is a characteristic of onset in this area.Pathogenic infection has significant difference among the age groups,but difference between genders has no statistical significance.