儿童急性呼吸道肺炎支原体感染流行特点及与气候因素的关系探讨

Relationship between epidemiological features of acute respiratory tract infection due to mycoplasma pneumoniae in children and meterological factors

目的探讨儿童急性呼吸道肺炎支原体(mycoplasma pneumoniae,MP)感染流行特点及与气候因素的关系。方法选择2006年1月—2009年12月因急性呼吸道MP感染住院的患儿8 368例,运用实时聚合酶链式反应(polymerase chain reaction,PCR)检测鼻咽部分泌物中MP基因片段,采用定量酶联免疫吸附剂测定(enzyme linked immunosorbent assay,ELISA)检测血清中MP特异性抗体,同时收集2006—2009年苏州地区有关气象资料。计数资料组间率的比较采用χ2检验,各气象因素间的交互作用,自变量的筛选,则采用逐步回归分析,P<0.05为差异有统计学意义。结果 MP感染总阳性率为32.9%,2006—2009年分别为25.6%、29.0%、36.7%、40.0%,年度之间比较差异有统计学意义(χ2=127.96,P<0.05)。春、夏、秋、冬季分别为31.8%、38.8%、37.4%、23.3%,不同季节MP感染阳性率比较差异有统计学意义(χ2=139.77,P<0.05)。MP感染好发于每年的5—11月,即夏秋季节,流行月份(2009年11月)可高达55.4%。MP感染与月平均气温呈正相关(r=0.529,P<0.05),与其他气候因素无相关性。结论 MP是儿童急性呼吸道感染的主要病原之一,不同季节感染率不同,气候因素尤其是温度,对MP的流行起着重要作用。

Objective To discuss the epidemiology of mycoplasma pneumoniae（MP） infection in children with acute respiratory tract infections （ARTIs） and its relationship with meterological factors.Methods A total bf 8 368 hospitalized children with AR- TIs from January 2006 to December 2009 were enrolled in this study.Nasopharyngeal aspirates were collected from all children and tested for MP-DNA with polymerase chain reaction （PCR） and for MP specific antibody with enzyme linked immunosorbent assay （ELISA）.Meanwhile,meterological data were collected in Suzhou in 2006-2009.X2 test was used to process measurement data for ratio in different groups.The interaction between meteorological factors and the selection of independent variables were ana- lyzed by ste＇pwise regression.The result of P〈0.05 was considered statistically significant.Results MP was identified in 32.9% of 8 368 specimens.The incidence of MP infection was 25.6% ,29.0% ,36.7% and 40.0% respectively from 2006 to 2009,which showed an annually significant difference（x=127.96,P〈0.05）.The incidence of MP infection was 31.8% in spring,38.8% in sum- mer,37.4% in autumn and 23,3% in winter,showing a significant difference（x2=139.77,P〈0.05）.MP infection was frequently de- tected in summer and autumn,that from May to November,every year,which reached its peak onset in November（55.4%）.MP infec- tion was positively correlated with the average monthly temperature（r=0.529, P〈0.05）and showed no correlation with other meteo- rological factors.Conclusion MP is one of the major pathogens in children with acute respiratory infections.The incidence of a- cute respiratory infections varies with different seasons.Meterological factors,especial temperature,play an important role in the prevalence of MP.