小儿急性下呼吸道感染的病原学研究

Etiology of Acute Lower Respiratory Infection in Children

目的 探讨小儿急性下呼吸道感染的病原学特点及其与临床的关系。方法 采用痰细菌培养、痰支原体培养、APAAP法、酶联免疫法 (ELISA)等对 2 46例下呼吸道感染病儿进行多病原学研究。结果 单纯病毒感染占 5 0 .4% ,细菌感染 4.1% ,支原体感染 5 .7% ,混合感染 2 7.2 % ,病原不明 12 .6 %。毛细支气管炎组中无单纯细菌或支原体感染 ;而支气管炎组中无 1例是单纯细菌感染。 <1岁组的混合感染率 37.6 %高于 1岁以上年龄组 (16 .5 3% ) (P <0 .0 5 )。CRP的升高在细菌与病毒感染间差异显著 (P <0 .0 5 )。结论 病毒感染和混合感染构成小儿急性下呼吸道感染的主要病原 ;婴儿中混合感染率高 ,而CRP的升高有助于早期判断细菌感染。

Objective To study the etiology of acute lower respiratory infection (ALRI) in children. Methods The multiple pathogens of 246 cases of ALRI were studied by the culture of bacteria and Mycoplasma pneumoniae of sputum and the methods of alkaline phosphatase anti alkaline phosphatase (APAAP) and ELISA. Results Of the 246 patients with ALRI, 50.4% were viral infection, 4.1% were due to bacterial infection and 27.2% were viral mixed with bacterial infection. The incidence of Mycoplasma pneumoniae infection was 5.7% and unknown pathogens were approximately 12.6% . There was no simple bacterial or Mycoplasma pneumoniae infection in the bronchiolitis group, and no simple bacterial infection in the bronchitis group was found either. The rate of mixed infection in the under 1 year old patients was higher than that in the over 1 year old group (χ 2= 13.77 , P< 0.05 ). The level of serum C reactive protein (CRP) in children with bacteria infection was higher than that in children with viral infection (χ 2= 34.44 ,P< 0.05 ). Conclusions Viral and mixed infections are prominent pathogens of ALRI. Mixed infection is the most common in infants with ALRI. CRP estimation may be helpful in distinguishing bacterial infection from viral infection early.