402例社区获得性肺炎的发病状况及病原学分析

The Incidence and Etiology of Community Acquired Pneumonia of 402 Community-Acquired Pneumonia

目的分析研究发热患者中社区获得性肺炎(CAP)的发病状况、病原学特点。方法对北京世纪坛医院发热门诊2007年度就诊患者进行胸部X线摄片,采用统一诊断标准进行CAP诊断,记录年龄、性别、发热天数、咳嗽、咳痰、外周末梢血常规检查和病原学结果,进行统计分析。结果 6539例发热门诊就诊患者中共诊断CAP 402例,总体患病比例为6.1%,CAP患病比例随年龄增大而逐渐升高,CAP患者外周血白细胞计数不升高总体比例为50.7%,无咳嗽、咳痰的CAP患者占到36.8%。402例CAP患者中共有121例病原学检测阳性,居前三位的病原体分别为肺炎支原体23.1%(28例/121),肺炎链球菌20.7%(25/121例)、流感嗜血杆菌11.6%(14/121)。121例病原体阳性的CAP病例中,发现混合感染14例(11.6%)。结论在发热门诊患者中CAP患病比例随年龄增加而升高,无咳嗽、咳痰症状的CAP患者占36.8%。肺炎链球菌和流感嗜血杆菌仍然是CAP中的常见致病菌,但非典型病原体尤其是肺炎支原体感染已占据首位,混合感染比率较高,以肺炎支原体混合细菌或病毒感染多见。

Objective To analyze the incidence,etiology and clinical characteristics of community acquired pneumonia（CAP） among the outpatients with fever.Methods We used chest X-rays for fever who were recruited since 2007,the patient＇s age,gender,days of fever,cough,sputum,peripheral blood count and etiology of CAP were recorded.Results Of all the 6539 fever outpatients,402 were diagnosed as CAP with the incidence rate of 6.1%.The prevalence increased with the age.50.7% of CAP patients with white blood cell count was not elevated.Of the 402 CAP patients,36.8%（148/402） presented no respiratory symptoms and 30.1%（121/402） had positive etiology.The top 3 pathogens were mycoplasma pneumoniae（23.1%）,streptococcus pneumoniae（17.3%） and haemophilus influenzae（9.1%）.Among the 121 etiology positive patients,14 cases were mixed infection.Conclusion Fever outpatient CAP and incidence increased with age.Streptococcus pneumoniae and haemophilus influenzae were common pathogens in CAP,however,atypical pathogens Mycoplasma pneumoniae infection had occupied the first position,the mixed infection rate is higher.