儿童呼吸道感染病原体血清流行病学分析

Epidemiological analysis of respiratory tract infections in children

目的了解西安地区急性呼吸道感染患儿病原体血清IgM检出情况,分析呼吸道病原体流行病学特征,为早期预防和临床诊治提供参考依据。方法采集2014年10月-2015年9月儿童病院门诊和住院急性呼吸道感染1 406例患儿的血清标本,利用间接免疫荧光法检测嗜军团菌（LP1）、肺炎支原体（MP）、肺炎衣原体（CPn）、腺病毒（ADV）、呼吸道合胞病毒（RSV）、A型流感病毒（INFA）、B型流感病毒（INFB）、副流感病毒（PIVs）和Q热立克次体（COX）特异性IgM,数据采用SPSS 21.0软件进行统计分析。结果共采集1 406例患儿血清标本,检测阳性582例,阳性率为41.4%,其中MP检出率最高为24.3%;女童MP-IgM检出率为29.3%,显著高于男童MP-IgM检出率20.9%;LP1-IgM检出率随年龄增长而增高,在10-15岁阶段检出率最高达13.8%;MP-IgM、INFB检出率均在7-9岁最高,差异均有统计学意义（P〈0.05）。结论儿童急性呼吸道感染主要由MP、INFB、LP1引起,混合感染中MP合并INFB较为常见;同时,呼吸道各病原体在各年龄段及不同月份流行特征均不同,因此,需有针对性的做好预防治疗工作。

OBJECTIVE To understand the detection condition of IgM and analyze the epidemiologic features of IgM of pathogens causing acute respiratory tract infections in children in Xi′an,so as to provide the basis for early prevention and clinical diagnosis and treatment.METHODS A total of 1406 serum specimens of the outpatients and the hospitalized patients with acute respiratory tract infections in children were collected from Oct.2014 to Sep.2015.IgM against pathogens were detected by indirect immunofluorescence to Legionella pneumophila serogroup1（LP1）,Mycoplasma pneumonia（MP）,Chamydophila pneumonia（CPn）,Adenovirus（ADV）,Respiratory syncytial virus（RSV）,Influenza A（INFA）,Influenza B（INFB）,Parainfluenza 1,2and 3（PIVs）,Coxiella burnetii（COX）.Statistical analysis was performed by SPSS 21.0.RESULTS A total of 1406 serum specimens were detected,and there were 582 positive cases（positive rate of 41.4%）.The MP was the dominant pathogen with the positive rate of 24.3%.The detection rate of MP-IgM was 29.3%in girls which was significantly higher than that in boys（20.9%）.The positive rate of LP1-IgM increased with the age growing,which had the highest positive rate in 10-15year age group（13.8%）.The positive rate of MP-IgM and INFB had the highest positive rate in 7-9year age group,and the difference was significant（P〈0.05）.CONCLUSION MP,INFB and LP1 are the main pathogens in children′s acute respiratory tract infection in Xi′an.MP co-infection with INFB was the most common mixed infection.Meanwhile,different respiratory pathogens have different characters of prevalent in different age groups and different month distribution,so it′s necessary to make protection and treatment measures according to respective epidemic regularity.