2018-2019年北京市儿童社区获得性肺炎的病原学分析及临床特点

Etiological analysis and clinical characteristics of community-acquired pneumonia in children in Beijing from 2018 to 2019

目的了解儿童社区获得性肺炎(CAP)患儿的病原分布及临床特点,为其治疗和预防提供依据。方法选取2018年12月至2019年11月在北京市昌平区中西医结合医院住院的486例CAP患儿为研究对象。回顾性分析其病原检出率、病原检出情况与年龄关系、不同病原检出的季节分布特点,以及不同病原感染的临床特点(包括发热、热性惊厥、咳嗽、喘息)。结果CAP患儿肺炎支原体检出率最高,其次为病毒。病毒检出率从高到低依次为甲型流感病毒、乙型流感病毒、呼吸道合胞病毒、人副流感病毒、腺病毒。肺炎支原体好发年龄为学龄儿童,秋季高流行;呼吸道合胞病毒好发年龄为婴儿,冬季高流行,更容易引起喘息;流感病毒冬春季流行,较其他病毒容易发生中高度热,可导致热性惊厥,甲型流感病毒好发年龄为幼儿,冬季高流行,乙型流感病毒春季高流行;人副流感病毒夏季高流行。差异均有统计学意义(P<0.05)。结论肺炎支原体和病毒在儿童CAP占有重要地位,要针对病原特点做好对应的防护策略及治疗措施。

Objective To understand the pathogen distribution and clinical characteristics in children with community-acquired pneumonia(CAP),and to provide a basis for the treatment and prevention.Methods A total of 486 children with CAP hospitalized in Beijing Changping Hospital of Integrated Chinese and Western Medicine from December 2018 to November 2019 were selected as the study subjects.The pathogen detection rate,the relationship between pathogen detection and age,the seasonal distribution characteristics of different detected pathogens,and the clinical characteristics of different pathogen infections(including fever,febrile seizure,cough and wheezing)were retrospectively analyzed.Results The detection rate of mycoplasma pneumonia(MP)in children with CAP was the highest,followed by the virus.The descending order for virus detection rates was influenza A virus,influenza B virus,respiratory syncytial virus,human parainfluenza virus and adenovirus.MP was prevalent in school-age children with peaks in autumn.The respiratory syncytial virus was prevalent in infants with peaks in winter and more likely to cause wheezing.Influenza virus was prevalent in winter and spring,more prone to cause moderate to high-grade fever than other viruses and could lead to febrile seizures.Influenza A virus was prevalent in young children with peaks in winter while influenza B virus was highly prevalent in spring.The human parainfluenza virus was highly prevalent in summer.The differences were statistically significant(P<0.05).Conclusion MP and virus play an important part in children with CAP.The corresponding protective strategies and treatment measures shall be taken according to the pathogenic characteristics.