合肥市某三甲医院2021至2023年发热儿童临床体征及呼吸道病原抗体监测分析

Analysis of clinical signs and respiratory etiology surveillance for children with fever in Hefei,Anhui Province of China,from 2021 to 2023

目的:分析发热儿童呼吸道病原体分布及临床体征,探讨呼吸道病原体检出影响因素。方法:收集发热儿童人口特征学资料、临床表现和体征、实验室检查等资料,统计其流行病学特征、临床体征和病原抗体分布,分析不同因素对病原抗体阳性率的影响。结果:发热儿童2月、3月、6月住院比例较高,分别占同期儿科住院病例的6.50%、5.23%、4.85%;临床症状前五位分别是咽部充血、抽搐、呼吸音粗、扁桃体肿大、咳嗽;52.84%的发热儿童呼吸道病原体抗体阳性,联合感染占31.40%,肺炎支原体、副流感、甲流、乙流感染分别占48.91%、17.03%、1.75%、1.75%,各病原体阳性率之间差异有统计学意义(P<0.001);不同的年份、月份、症状、白细胞值、SAA值其病原体阳性率不同,且差异均有统计学意义(P=0.011、0.017、0.019、0.001、0.044)。结论:发热儿童首要症状为咽部充血,感染病原体主要为肺炎支原体。发热儿童呼吸道感染性疾病监测时建议关注2月、3月、11月,咽部充血、扁桃体肿大,白细胞异常、SAA异常的患儿。

Objective:To analyze the distribution of etiological and clinical signs of children with fever,and investigate the influence factors on respiratory etiology surveillance.Methods:The children with fever as our research objects,and collect their demographic data,clinical signs,laboratory data were selecte.To analyze the epidemiological characteristics,distribution of clinical signs and pathogenic,and the influencing factors of pathogenic.Results:There were more children with fever had to be hospitalized in February,March and June,accounting for 6.50%,5.23%and 4.85%of the all pediatric patients in the same hospital stay.The top five clinical symptoms were pharyngeal congestion,convulsions,coarse breathing sounds,swollen tonsils,and cough.The percentage of pathogens detected was 52.84%,the co-infection rate was 31.40%,48.91%were Mycoplasma pneumoniae,17.03%were Parainfluenza virus,and influenza A and influenza B were 1.75%,respectively.The detection rate of different pathogens was significantly different(P<0.001).The detection rate of etiological antibody were different in different years,months,symptoms,WBC and SAA,and the differences were statistically significant(P value was 0.011,0.017,0.019,0.001,0.044,respectively).Conclusion:The primary symptom of children with fever is pharyngeal congestion,and the main pathogen they infected is mycoplasma pneumonia.It is recommended to pay attention to children with pharyngeal congestion,tonsillar enlargement,abnormal white blood cells,and abnormal SAA in February,March,and November,when the infection disease surveillance was carried.