3227例呼吸道感染患者的病毒及非典型病原体检测分析

Detection of viruses and atypical pathogens in 3227 cases with respiratory tract infection

目的探讨北京地区呼吸道感染的病原学流行特点,为临床诊疗提供病原学依据。方法采用间接免疫荧光法检测人血清中8种呼吸道病原体的Ig M抗体,根据不同性别、不同人群、不同年份和不同季节的病原体阳性率进行统计分析。结果 3 227例患者中病原体的阳性率为39.3%,其中甲型流感病毒阳性率最高,其他依次为:嗜肺军团菌、乙型流感病毒、腺病毒、肺炎支原体、副流感病毒、肺炎衣原体和呼吸道合胞病毒;男性与女性患者病原体阳性率结果比较无统计学差异(P>0.05);不同人群病原体感染阳性率有明显差异,成人组明显高于儿童组,结果比较差异有统计学意义(P<0.05);成人组的嗜肺军团菌、甲型流感病毒、乙型流感病毒和肺炎衣原体阳性率显著高于儿童组,而肺炎支原体和腺病毒阳性率显著低于儿童组,结果比较差异有统计学意义(P<0.05);2014年病原体阳性率显著高于2013年阳性率,两年间比较差异有统计学意义(P<0.05);春季病原体阳性率显著高于夏季、秋季和冬季的阳性率,结果比较差异有统计学意义(P<0.05)。结论本地区呼吸道感染病原体阳性率在不同的人群、年份和季节性存在差异,在性别间无差异,感染病原体以甲型流感病毒和嗜肺军团菌为主,甲型流感病毒、乙型流感病毒、腺病毒、肺炎支原体、呼吸道合胞病毒和肺炎衣原体流行有季节性特点,副流感病毒和嗜肺军团菌全年散发,未见明显季节性变化。

Objective To investigate the etiological epidemic characteristics of respiratory tract infection in cases ofBeijing area and to provide etiological basis for clinical diagnosis and treatment. Methods Indirect immunofluorescencemethod was used to detect the Ig M antibody of eight different kinds of respiratory tract pathogens in sera of the patients. Thepositive rates of pathogens were analyzed statistically based on different genders, types（adults or children）, years and seasons.Results The total positive rate of pathogens in 3 227 cases was 39.3%. Among the eight different kinds of respiratory tractpathogens, the positive rate of influenza A（INFA）was the highest, followed by Legionella pneumophila（LP）, influenza B（INFB）, adenovirus（ADV）, Mycoplasma pneumoniae（MP）, parainfluenza virus（PIV）, Chlamidia pneumoniae（CP）andrespiratory syncytial virus（RSV）.There was no significant difference between male and female patients in the positive rate ofpathogens. The positive rate of pathogen in adult patients was significantly higher than that of child patients, showingsignificant differences between them. The positive rates of LP, INFA, INFB and CP in cases of adult group were significantlyhigher than that of the child group while the positive rates of MP and ADV in children group were significantly higher than thatof the adult group and all the differences were statistically significant. The positive rate in 2014 was significantly higher thanthat in 2013 revealing significant differences. The positive rate during spring was significantly higher than that in summer,autumn and winter revealing significant differences. Conclusions The positive rates of respiratory tract pathogen inpopulation of Beijing area showed significant differences between adults and children, years and seasons and showed nosignificant difference with genders. The main pathogens were INFA and LP. The prevalence of INFA, INFB, ADV, MP, RSVand CP had seasonal characteristics while PIV and LP were prevalent throughout the year with no obvious seasonal changes.