3820例呼吸道感染患儿病原体的检测结果及流行病学特点分析

Analysis of respiratory pathogens and epidemiological characteristics of 3820 children with respiratory tract infection

目的:了解垫江地区儿童呼吸道病原体流行情况,为疾病的预防和诊治提供实验室依据。方法:回顾性分析2018年1月至2020年10月本院收治的3820例呼吸道感染患儿入院时检测的血常规、血清淀粉样蛋白A(Serum amyloid A,SAA)、C反应蛋白(C-reactive protein,CRP)结果及采用间接免疫荧光法检测的11项呼吸道病原体IgM抗体结果。结果:病毒IgM抗体总检出率为51.65%(1973/3820),以流感病毒B(Influenza virus B,INFB)、流感病毒A(Influenza virus A,INFA)和肺炎支原体(Mycoplasma pneumoniae,MP)感染为主;在1973例呼吸道病原体阳性患者中有321例患者存在混合感染,混合感染率为16.27%;女性患儿阳性率高于男性患儿(χ^(2)=9.67,P=0.002);学龄前组与学龄组呼吸道病原体阳性率较高,婴儿组最低,差异具有统计学意义(P<0.05)。夏季病原体阳性检出率明显低于其它三个季节(χ^(2)=25.62,P=0.00);肺炎衣原体(Chlamydia pneumoniae,CP)组SAA水平最高,明显高于副流感病毒(Parainfluenza virus,PIV)组(P<0.05),INFA组和呼吸道合胞病毒(Respiratory syncytial virus,RSV)组白细胞(White blood cells,WBC)明显高于其它4组,其中INFA组以单核细胞(Monocytes,MONO#)增高为主,RSV组以淋巴细胞(Lymphocyte,LYMPH)增高为主。结论:INFB,INFA和MP是垫江地区儿童最主要的呼吸道感染病原体,不同性别、不同年龄段和不同季节病原体感染率存在显著差异,且感染不同类型病原体后实验室检测结果也有所差异,应针对性采取有效的措施预防感染和合理诊治。

Objective:To understand the prevalence of respiratory pathogens in children in Dianjiang area,in order to provide laboratory basis for disease prevention and diagnosis.Methods:The results of serum amyloid A(SAA),Creactive protein(CRP)and eleven IgM antibodies of respiratory pathogens detected by indirect immunofluorescence assay in 3820 children with respiratory tract infection admitted to our hospital from January 2018 to October 2020 were retrospectively analyzed.Results:The total detection rate of virus IgM antibody was 51.65%(1973/3820),and INFB,INFA and MP were the main infections;Among the 1,973 patients who tested positive for respiratory pathogens,321 patients had mixed infection,and the mixed infection rate was 16.27%.The positive rate of female children was higher than that of male children(P=0.002).The positive rate of respiratory pathogens was higher in preschool group and school-age group,and lowest in infant group,and the difference was statistically significant(P<0.05).The positive pathogen detection rate in summer was significantly lower than that in other three seasons(P=0.00);CP group had the highest SAA level,which was significantly higher than PIV group(P<0.05),WBC of INFA group and RSV group were significantly higher than those of the other 4 groups.In INFA group,mononuclear cell proliferation was dominant,while lymphocyte proliferation was dominant in RSV group.Conclusion:INFB,INFA and MP are the main respiratory infection pathogens in children in Dianjiang area.There were significant differences in pathogen infection rates among different genders,ages and seasons.In addition,the results of laboratory tests after infection with different types of pathogens are also different,so effective measures should be taken to prevent infection and make reasonable diagnosis and treatment.