天津市住院儿童肺炎支原体和乙型流感病毒感染情况及其与空气污染相关性的初步研究

Relationship between air pollutants and Mycoplasma pneumoniae and influenza B virus infection among hospitalized children in Tianjin

目的了解并探讨天津市住院儿童肺炎支原体(MP)和乙型流感病毒(FLuB)IgM抗体检出情况及其与空气污染的相关性。方法收集天津市2014年5月—2015年4月天津市空气质量监测数据,并采集同期于天津市儿童医院住院的急性呼吸道感染患儿血清,采用间接免疫荧光法检测MP-IgM和FLuB-IgM抗体,了解其检出情况并分析其与空气污染之间的相关性。结果共检测16 028例患儿,其中MP抗体阳性者2 103例,检出率为13.12%;FLuB抗体阳性者2 721例,检出率为16.98%。男童的MP-IgM抗体和FLuB-IgM抗体检出率均低于女童,差异有统计学意义(P<0.05)。MP-IgM抗体在10月检出率最高(19.47%),1月最低(10.63%);FLu B-IgM抗体在5月检出率最高(24.54%),12月检出率最低(12.88%)。MP-IgM抗体在秋季感染率最高(14.57%),冬季最低(12.19%);FLuB-IgM抗体在夏季感染率最高(20.26%),秋季最低(13.78%)。MP-IgM抗体以学龄期组患儿检出率最高(20.58%),婴儿组最低(3.25%);FLuB-IgM抗体以学龄前期组患儿检出率最高(30.68%),婴儿组最低(2.31%)。调查期间呼吸道感染住院病例数与该市空气质量指数(AQI)、PM_(2.5)、PM_(10)、NO_2、SO_2浓度均呈正相关,其中与SO_2浓度的相关性最强(r=0.839);MP阳性例数与AQI、PM_(2.5)浓度呈正相关,其中与PM_(2.5)浓度的相关性最强(r=0.619)。结论天津市儿童医院2014年5月—2015年4月住院患儿的FLuB-IgM抗体感染率高于MP-IgM抗体,二者在不同月份、季节及年龄上均有各自流行特点;调查期间空气污染严重,呼吸道感染住院病例数与AQI、空气污染物浓度有关,MP阳性例数与AQI、PM_(2.5)浓度有关。

Objective To understand and explore the detection rate of the antibodies of Mycoplasma pneumoniae（MP）-IgM and influenza B virus（FLuB）-IgM among hospitalized children in Tianjin and the relationship with air pollutants. Methods The data of air quality monitoring in Tianjin from May 2014 to Apr. 2015 and the serum of hospitalized children with acute respiratory infection（ARI） were collected during the same period. The antibodies of MP-IgM and FLuB-IgM were detected by indirect immunofluorescence. The relationship between the detection rate of the antibodies of MP-IgM and FLuB-IgM and the air pollutants were studied. Results Among 16 028 tested samples, 2 103 cases were MP positive（13.12%） and 2 721 cases were Flu B positive（16.98%）. There was significant difference in the positive rate of MP-IgM and FLuB-IgM antibody between different genders, male infection rates were lower than female. The highest positive rate was observed in October（19.47%） and the lowest in January（10.63%） for MP-IgM antibody,and for FLuB-IgM antibody, the highest in May（24.54%） and the lowest in December（12.88%）. For MP-IgM antibody the highest positive rate was observed in autumn（14.57%） and the lowest in winter（12.19%）, for FLuB-IgM antibody the highest in summer（20.26%） and the lowest in autumn（13.78%）. For MP-IgM antibody the highest positive rate was observed in school age children（20.58%） and the lowest in infants（3.25%）, for FLuB-IgM antibody the highest in preschool age children（30.68%） and the lowest in infants（2.31%）. During the survey, the levels of AQI and the concentrations of PM（2.5）, PM（10）, NO2 and SO2 had significant positive correlation with hospitalized cases, and the intensity of correlation of SO2 was the strongest（r=0.839）; The positive cases of MP showed significantly positive correlation with AQI and the concentrations of PM2.5, especially between PM（2.5） and MP（r=0.619）. Conclusion The positive rate of FLuB-IgM antibody is higher than MP-IgM antibody in hospitalized children with ARI in Tianjin Children ＇s Hospital from May 2014 to Apr. 2015.The positive rates of MP-IgM antibody and FLuB-IgM antibody have their own characteristics in different months, seasons and ages. Tianjin has severe air pollution during the survey, AQI and air pollutants have correlation with hospitalized patients number, AQI and the concentration of PM（2.5） has correlation with positive cases of MP.