上海崇明地区0～12岁儿童呼吸道病原体抗体检测分析

Detection and analysis of IgM antibody against respiratory pathogens in children aged 0-12 years in Chongming area of Shanghai

目的了解上海市崇明区0~12岁儿童8种常见呼吸道病原体特异性IgM的检测情况,指导临床治疗及合理用药。方法收集2015年4月至2018年11月上海交通大学附属新华医院崇明分院,因呼吸道感染的0~12岁患儿4272例血清标本,采用间接免疫荧光法同时检测呼吸道合胞病毒(RSV)、腺病毒(ADV)、嗜肺军团菌(LP)、肺炎衣原体(CP)、肺炎支原体(MP)、流感病毒A(IVA)、流感病毒B(IVB)、副流感病毒(PIV)8种呼吸道病原体的IgM抗体,比较不同季节和不同年龄段感染率。结果4272例样本中共检出IgM抗体阳性939例(21.98%),其中单一病原体感染773例,占82.32%(773/939),混合感染166例,占17.68%(166/939)。所调查样本中,阳性被检者中MP阳性率最高,占40.15%,其次为IVB、IVA、CP、PIV、LP、RSV、ADV,分别占35.68%、22.47%、10.44%、4.15%、2.24%、2.02%、1.60%。不同年龄段儿童,CP、MP、IVA、IVB、PIV感染率有显著性差异。其中学龄期组CP和MP阳性率最高,学龄前期组IVA和IVB阳性率最高,幼儿组IVB、MP和IVA阳性率最高。该地区不同季节的病原体感染率差异有统计学意义(P<0.05),主要表现为CP、IVA和IVB。CP感染率夏秋高于冬春季节,IVB冬春季节高于夏秋,IVA感染率秋冬季高于春夏。女童总体阳性率为25.98%(489/1882),高于男童18.83%(450/2390),差异有统计学意义(P<0.001)。结论掌握该地区0~12岁儿童呼吸道病原体感染的流行病学特点,有助于提高医生的诊断和治疗。

Objective To investigate the detection of specific IgM of 8 common respiratory pathogens in children aged 0-12 years with respiratory tract infection in Chongming District of Shanghai,and to guide clinical treatment and rational use of drugs.Methods Serum samples were collected from 4273 children aged 0-12 years with respiratory tract infection in Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiaotong University from April 2015 to November 2018.Respiratory syncytial virus(RSV),adenovirus(ADV),Legionella pneumophila(LP),Chlamydia pneumoniae(CP),Mycoplasma pneumoniae(MP),Influenza A virus(IVA),Influenza B virus(IVB),parainfluenza virus(PIV)IgM antibodies to 8 respiratory pathogens.The infection rates in different seasons and ages were compared.Results Totally 939 cases(21.98%)were positive for IgM antibody in 4272 samples,including 773 cases(82.32%)with single pathogen infection and 166 cases(17.68%)with mixed infection.Among the samples investigated,the positive rate of MP was the highest(40.15%),followed by IVB,IVA,CP,PIV,LP,RSV,and ADV,counted for 35.68%,22.47%,10.44%,4.15%,2.24%,2.02%and 1.60%,respectively.There were significant differences in the infection rates of CP,MP,IVA,IVB and PIV among children of different ages.The positive rate of CP and MP was the highest in school-age group,and the positive rate of IVA and IVB was the highest in preschool group,and the positive rate of IVB,MP and IVA was the highest in early childhood group.The difference of virus infection rate in different seasons in this area was statistically significant(P<0.05),mainly manifested as CP,IVA and IVB.The CP infection rate in summer and autumn was higher than that in winter and spring,the IVB infection rate in winter and spring was higher than that in summer and autumn,and the IVA infection rate in autumn and winter was higher than that in spring and summer.The overall positive rate of girls was 25.98%(489/1882),which was significantly higher than that of boys(18.83%,450/2390,<0.001).Conclusion Mastering the epidemiological characteristics of respiratory tract pathogen infection in children aged 0-12 years in this area is helpful to improve the diagnosis and treatment of doctors.