广州市肺炎支原体致儿童呼吸系统感染的流行病学及外周血淋巴细胞亚群水平的初步分析

Preliminary analysis of epidemiology and level of lymphocyte subsets in children with respiratory infection caused by mycoplasma pneumonia

目的探讨2020年至2021年广州市儿童呼吸道肺炎支原体(MP)感染的流行病学特征及感染患儿外周血淋巴细胞亚群含量变化。方法收集2020年1月至2021年12月就诊于广东省妇幼保健院的17453例呼吸道感染患儿采用间接免疫荧光法(IFA)检测的血清肺炎支原体抗体(MP-IgM)结果;从MP-IgM阳性的患儿中选取同时检查淋巴细胞亚群的443例作为观察组与对照组进行外周血淋巴细胞亚群(CD3^(+)、CD19^(+)、CD16^(+)CD56^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平的统计学分析。结果17453例呼吸道感染的患儿中共有4388例MP-IgM抗体检测阳性,总阳性率25.14%;MP-IgM阳性率秋季最高(30.15%),冬季最低(19.54%);MP-IgM阳性率在6月至11月持续保持在较高水平,5月份最低;男性、女性患儿阳性率分别为21.94%、30.39%,MP-IgM阳性率婴儿组(0~<1岁)最低,学龄前儿童组(3~<7岁)最高;呼吸道8项病毒感染检测,伴MP-IgM阳性的混合感染中流感病毒B(IV-B)阳性率最高(44%),肺炎衣原体(CPn)阳性率最低(1%);观察组与对照组患儿CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平差异有统计学意义(P<0.01)。结论MP感染好发于秋季,女性感染阳性率高于男性,学龄前儿童阳性率较高;伴MP-IgM阳性的其他呼吸道8项感染中以IV-B混合阳性率最高;患儿的淋巴细胞亚群水平可提示其感染状态,临床上加强对患儿免疫状态的观察与治疗,可以为临床用药与治疗提供指导。

Objective To explore the epidemiological characteristics of mycoplasma pneumoniae(MP)infection in children's respiratory from 2020 to 2021 in Guangzhou,and to observe the changes in the levels of peripheral blood lymphocyte subsets in infected children.Methods Serum mycoplasma pneumoniae antibody(MP-IgM)were collected from 17453 children using indirect immunofluorescence assay(IFA)with respiratory tract infection who visited Guangdong Women and Children Hospital from January 2020 to December 2021.Among them,443 children who were positive for MP-IgM and had undergone lymphocyte subset testing were selected as the observation group and control group.The levels of peripheral blood lymphocyte subsets(CD3^(+),CD19^(+),CD16^(+)CD56^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))were analyzed statistically.Results Among the 17453 children with respiratory tract infections,4388 cases were positive for MP-IgM,with a total positive rate of 25.14%.The positivity rate of MP-IgM is highest in autumn(30.15%)and lowest in winter(19.54%);the positive rate of MP-IgM antibody remained at a high level from June to November,peaking in May.The positive rates of male and female children were 21.94%and 30.39%,respectively.The MP-IgM was lowest in the infant group(0~<1 years old),and highest in the preschool children(3~<7 years old).Among the eight respiratory tract infections,the highest positive rate for influenza virus B(IV-B)was 44%in the mixed infection with MP-IgM,while the lowest positive rate for chlamydia pneumoniae(CPn)was 1%.There were significant differences in the levels of CD4^(+),CD8^(+),CD4^(+)/CD8^(+)between the observation group and the control group(P<0.01).Conclusions MP infection are most prevalent in autumn,with a higher positive rate in female children than in male children and a higher positive rate in preschool age children.Among the eight other respiratory tract infections associated with MP-IgM,the highest mixed infection rate was found for IV-B.The level of lymphocyte subsets can indicate the infection status.In clinical practice,strengthening the observation and treatment of the immune status of children can provide guidance for clinical medication and treatment.