呼吸道感染患儿MP与INFB水平的诊断价值分析

MP and INFB levels in children with respiratory tract infections and its diagnostic value analysis

目的探究儿童呼吸道感染患者的肺炎支原体(MP)、乙型流感病毒(INFB)阳性检出情况,为儿童呼吸道感染的临床诊治提供参考。方法选取医院2015年4月-2016年8月采用间接免疫荧光法对300例儿童呼吸道感染患者的血清样本进行MP、INFB、Q热立克抗体(COX)、嗜肺军团菌1型(LP1)、肺炎衣原体(CP)、腺病毒(ADV)、呼吸道合胞病毒(RSV)、甲型流感病毒(INFA)、副流感病毒(PIVs,1型、2型、3型)共计9种病原体的IgM抗体检测,对呼吸道感染患儿单一病原体感染和多种病原体混合感染情况进行观察分析,并从季节、患儿年龄分段入手,对比不同季节、不同年龄段患儿单一MP感染、单一INFB感染及MP+INFB感染的发生比例。结果 300例呼吸道感染患儿当中共检出病原体阳性感染136例,阳性率45.33%;检出病原体以MP、INFB为主,其中MP阳性有104例,阳性率为34.67%,占总阳性例数的76.47%;INFB阳性有47例,阳性率为15.67%,占总阳性例数的34.56%;混合感染共计45例,其中以MP+INFB感染最为常见,占阳性病例的17.65%;患儿在春冬季出现单一MP感染、单一INFB感染以及MP+INFB混合感染的比例明显大于夏秋季,差异比较有统计学意义(P<0.05);婴儿组患儿出现单一MP感染、单一INFB感染以及MP+INFB混合感染的比例分别为22.03%、10.53%、12.50%,其感染构成比与幼儿组、儿童组两组患儿比较存在显著差异(P<0.05),而幼儿组、儿童组两组之间比较并无明显差异。结论儿童呼吸道感染以MP、INFB感染为主要病原体,MP容易与其他病原体发生混合感染;MP、INFB感染的发病年龄多见于1岁以上,且与季节密切相关,以春冬季为高发季节;通过检测呼吸道常见9种病原体能够明确呼吸道感染患儿的病原体感染情况,为临床合理诊治提供参考。

OBJECTIVE To investigate the positive rate of Mycoplasma pneumoniae（MP）and influenza B virus（INFB）in children with respiratory tract infections,so as to provide references for the clinical diagnosis and treatment of respiratory tract infections in children.METHODS From Apr.2015 to Aug.2016,the MP,INFB,Q heat like antibody（COX）,legionella pneumophila type 1（LP1）,Chlamydia pneumoniae（CP）,adenovirus（ADV）,respiratory syncytial virus（RSV）,influenza A virus（INFA）and parainfluenza virus（PIVs,type 1,type 2and type3）of serum samples of 300 children with respiratory tract infections were detected by indirect immunofluorescence.The single pathogen infections and mixed pathogen infections in children with respiratory tract infections were observed and analysed,and from the aspects of season and age of children,the incidence of single MP infections,single INFB infections and MP＋INFB infections in children of different seasons and different ages were compared.RESULTS Totally 136 cases of positive pathogenic infections were detected in 300 cases of children with acute respiratory tract infection,and the positive rate was 45.33%.The main pathogens were MP and INFB,including 104 cases of MP positive,with the positive rate of 34.67%,and accounted for 76.47% of the total positive cases,and 47 cases of INFB positive,with the positive rate of 15.67%,and accounted for 34.56% of the total positive cases.There were 45 cases of mixed infections,and MP＋INFB infections were the most common,accounting for 17.65%in the positive cases.The ratios of single MP infections,single INFB infections and mixed infections of MP＋INFB in children in spring and winter were significantly higher than those in summer and autumn（P〈0.05）.The ratio of single MP infections,single INFB infection and mixed infections MP＋INFB in infant group were 22.03%,10.53% and 12.50%,and the infection composition ratio had significant differences with those in young children group and children group（P〈0.05）,However,there was no significant difference between young children group and children group.CONCLUSION MP and INFB infections are the main pathogens in children with respiratory tract infection,and MP is easy to mix infections with other pathogens.The age of onset of MP and INFB infection is always more than 1years old,and is closely related to the season,which is mainly in spring and winter.The pathogen infections in children with respiratory tract infections can be clearly defined by the detection of 9kinds of common respiratory pathogens,which can provide references for clinical rational diagnosis and treatment.