2006-2010年苏州地区住院儿童急性呼吸道合胞病毒和肺炎支原体感染的临床特征比较

Clinical Characteristics of Respiratory Syncytial Virus or Mycoplasma Pneumoniae Infection in Hospitalized Children with Acute Respiratory Tract Infection from 2006-2010 in Suzhou

目的:分析苏州地区儿童急性呼吸道合胞病毒(RSV)和肺炎支原体(MP)感染的临床特征,为临床治疗儿童RSV和MP感染提供理论指导和科学依据。方法:对苏州大学附属儿童医院2006年1月至2010年12月因急性呼吸道感染而住院的8 157例患儿的临床资料进行分析,应用实时PCR和直接免疫荧光法检测呼吸道分泌物中MP和RSV含量。结果:急性呼吸道感染患儿RSV检出率为13.7%(1 117/8 157),好发于冬春季节,流行月份检出率高达58.2%;MP检出率为11.0%(899/8 157),全年均可流行,好发于夏季,流行月份检出率高达26.0%。与MP比较,RSV男性发病率更高(P<0.01);MP感染患儿平均年龄明显比RSV感染患儿平均年龄大(P<0.05)。MP感染流行以咳嗽、发热为主要临床表现,而RSV感染以咳嗽、喘息为主要临床表现。RSV感染患儿入院诊断以毛细支气管炎为主,而MP感染患儿入院诊断以支气管肺炎及大叶性肺炎为主;MP感染患儿中性粒细胞升高比例及CRP水平高于RSV感染患儿(P<0.05),但血小板数及肝功能损害比例低于RSV患儿组(P<0.05);MP感染患儿潮气呼吸肺功能受损程度比RSV感染患儿轻(P<0.05);但两者平均住院时间比较差异无统计学意义(P>0.05)。结论:RSV和MP是儿童急性呼吸道感染的主要病原,其流行季节不同,且RSV感染患儿病情比MP感染患儿重,临床表现和实验室检查具有各自的特征性。

Objective： To study the clinical characteristics of respiratory syncytial virus （RSV） or mycoplasma pneumoniae （MP） infection in hospitalized children with acute respiratory tract infections （ARIs） from 2006 to 2010 in Suzhou. Methods： Eight thousand one hundred and fifty-seven hospitalized children with ARIs during 2006 to 2010, were tested for RSV and MP by direct fluorescenceantibody assay （DFA） and real-time PCR, respectively. Meanwhile, clinical data were collected and analyzed. Results： RSV was identified in 13.7% of 8,157 specimens as well as MP was identified in 11.0% of all patients. RSV was detected positively in winter and spring; the highest rate reached to 58.2%. MP was detected positively in summer and autumn; the highest rate reached to 26.0%. RSV infection was more common in male than in female （P〈0.01）. The ages of MP infection group were significantly older than those of RSV infection group. Fever and cough were the common symptoms in children with MP infection. Children for hospitalization were diagnosed with bronchial pneumonia or lobar pneumonia. Regarding to the laboratory results, children with MP infection had significantly high rate of neutrophils and CRP levels compared to children with RSV infection （ P〈0.05 ）, whereas platelet count and rate of liver functional lesion ratio were significantly low compared to children with RSV infection （P〈0.05）. Children with MP infection presented mild damage of lung function （ P 〈 0.05 ）. There was no significant difference in length of hospitalization between the two groups （P〉0. 05 ）. Conclusions： RSV and MP were most common pathogens in children with acute respiratory tract infections in Suzhou. MP and RSV infections have different seasonality. Children with RSV infection have severe symptoms compared to children with MP infection.