某三级综合医院4 391例儿童9种呼吸道病原体IgM抗体检测结果分析

Analysis on the Ig M Antibody to Pathogens Detected in 4 391 Cases of Child Respiratory Tract Infection in a Tertiary General Hospital

目的分析呼吸道感染患儿9种病原体IgM抗体检测结果,掌握本院儿童呼吸道病原体分布情况,为临床诊治提供科学参考.方法采用间接免疫荧光技术,对门诊和住院4391例呼吸道感染儿童血清中9种呼吸道病原体肺炎支原体(MP)、呼吸道合胞病毒(RSV)、肺炎衣原体(CPn)、Q热立克次体(COX)、乙型流感病毒(IFVB)、嗜肺军团1型(LP1)、腺病毒(ADV)、甲型流感病毒(IFVA)和副流感病毒(PIVs)的IgM抗体进行检测,分析这9种呼吸道病原体在不同性别、不同年龄、不同季节患儿血清中检出情况以及合并感染情况.结果4391例患儿呼吸道病原体检测阳性1564例,阳性率为35.62%,男性和女性阳性率分别为31.73%、40.83%,差异有统计学意义(P<0.05).前3位呼吸道感染病原体分别为MP1449例(33.00%)、PIVS348例(7.93%)、IFVB87例(1.98%).混合感染则以MP+PIVS为主,占56.01%.1~3岁年龄组患儿组呼吸道病原体检出率最高,差异有统计学意义(P<0.05),秋季发病率最高(P<0.05).结论MP、PIVS和IFVB是导致本院儿童呼吸道感染的主要病原体,且在不同年龄和季节的检出情况存在差异,临床应结合患者呼吸道病原体检测结果进行针对性治疗,合理使用抗菌药物,避免多重感染.

Objective The objective of this research is to analyze the IgM antibody test of 9 respiratory pathogens causing child respiratory tract infections,in the selected tertiary hospital to provide guidance for the clinical treatment of these infections.Methods This research the indirect immune-fluorescence technique was used to detect IgM against 9 respiratory tract infection pathogens in the serums of 4391 outpatient and inpatient child respiratory infection cases,including mycoplasma pneumonia(MP),syncytial virus(RSV),Chlamydia pneumonia(Cpn),Coxiella Burnetii(COX),Influenza B Virus(IFVB),Legionella pneumophila(LP1),adenovirus(ADV),influenza A virus(IFVA),and parainfluenza virus(PIVs).These pathogens were studied for the distributions of their detections from serums taken from different gender,different age groups,and different seasons,and their co-infections.Results 1564 cases among all the 4,391 cases of child respiratory infections were tested positive,positive rate is 35.62%.The positive rate for males and females were 31.73%and 40.83%respectively.The difference is statistically significant(P<0.05).The top three pathogens causing child respiratory tract infections were MP(1449 cases,33.00%),PIVs(348 cases,7.93%),IFVB(87 cases,1.98%).The primary co-infection was the co-infection of MP and PIVs,accounting for 56.01%of all infections.The positive rate was highest in the 1-3 year-old age group(P<0.05%)and highest in autumn(P<0.05).Conclusion The primary pathogens causing child respiratory tract infection in the selected tertiary hospital were MP,PIVs,and IFVB.There were statistically significant differences in the detection rate of these pathogens among different age groups and in different seasons.Clinical treatments thus should be customized for child patients with respiratory tract infections basing upon their pathogen test results so as to optimize the use of anti-bacterial drugs,and avoid multiple infections.