2011—2014年苏州儿童医院3596例喘息性呼吸道感染患儿病原学分析

Wheezing children in Suzhou Children's Hospital from 2011 to 2014:A pathogenic analysis of 3596 cases

目的 了解苏州大学附属儿童医院喘息患儿年龄、季节分布等临床资料及病原学特点。方法 收集2011年1月至2014年12月连续4年间因喘息住院治疗的3596例患儿病史及痰标本,均经多病原联合检测并结合病史资料进行分析。采用直接免疫荧光法检测7种常见呼吸道病毒,荧光定量PCR法检测肺炎支原体（MP）、肺炎衣原体（CP）及博卡病毒（HBoV）,RT-PCR法检测鼻病毒（HRV）及偏肺病毒（HMPV）等,并进行细菌培养。结果喘息主要发生在3岁及3岁以下年龄,以0～1岁最为多见。冬季喘息发生率最高,其次为春季和秋季。3596例喘息患儿总病原学检出率为63.0%（2264/3596例）。共检出病毒1458例（40.5%）,MP 342例（9.5%）,细菌1052例（29.3%）。各年龄组喘息患儿病毒检出率随年龄增加逐渐下降（P〈0.001）,MP检出率随着年龄增加逐渐升高（P〈0.001）,而细菌检出率差异无统计学意义（P〉0.05）。结论 喘息易发生于3岁及3岁以下儿童,冬季发生率最高。喘息儿童的病原检出具有明显的季节性及年龄特点。病毒是小年龄组的主要病原,而大年龄组则以细菌和MP较为多见。

Objective To study the characteristics of etiology and the distribution of age and season of wheezing children in Children＇ s Hospital Affiliated to Soochow University. Methods A total of 3596 cases of children hospitalized because of wheezing were collected from January 2011 to December 2014, including their medical history and sputum specimen. Multiple pathogenic joint detection was used to detect pathogens and analyze the data by combining with their medical history. Seven kinds of common respiratory virus （respiratory syncytial virus, adenovirus, influenza virus A, influenza virus B, parainfluenza 1, parainfluenza 2, parainfluenza 3） were detected by the direct immunofluorescence. MP, CP and HBoV were detected by fluorescence quantitative PCR. HRV and HMPV were detected by RT-PCR. Spu- tum was cultured for bacteria. Results Wheezing oceured mainly in children under three years old, especially in those under orle year old. The incidence of wheezing was the highest in winter, followed by spring and autumn. Summer was the lowest. Total etiology detection rate of 3596 wheezing children was 63.0% （2264/3596）. Virus was detected positive in 1458 cases （40.5%）. MP was detected positive in 342 cases （9.5%）. Bacteria were detected positive in 1052 cases （29.3%）. The virus detection rate of wheezing children gradually declined with age （P 〈 0.001 ）. The MP detection rate of wheezing children increased with age （P〈 0.001 ） , hut the bacteria detection rate had no obvious difference （P〉 0.05）. Conclusion Wheezing occurs mainly in children under the age of three years old, and the incidence of wheezing is the hizhest in winter. The pathogen detection of wheezing children has obvious seasonal and aze characteristics. Virusis the major pathogen in the younger group. Bacteria and MP are common in the elder group.