儿童肺炎支原体肺炎流行病学特征

Epidemiological characteristics of Mycoplasma pneumoniae pneumonia in children

摘要:

目的：了解儿童肺炎支原体肺炎流行病学特点，为临床诊治提供参考。方法：对2011年2月至2012年1月确诊为社区获得性肺炎的3156例住院患儿应用酶联免疫吸附法检测血清肺炎支原体抗体IgM，同时对肺炎支原体肺炎患儿的鼻咽分泌物进行7种呼吸道病毒抗原检测。结果：（1）3156例患儿中，肺炎支原体抗体IgM阳性检出427例，阳性率为13.53%，其中女性患儿感染率高于男性（16.30% vs 11.70%, P<0.01）。（2）＜1岁、1岁～、3岁～、6～14岁肺炎支原体抗体IgM检出率分别为3.6%、12.5%、19.2%、24.4%（P<0.01），其中≥3岁者总检出率高于<3岁者（P<0.01）。（3）不同季节肺炎支原体抗体IgM检出率不同，夏秋季节明显高于冬春季节（19.18% vs 9.61%，P<0.01）。（4）427例肺炎支原体抗体IgM阳性患儿中，合并呼吸道病毒感染 60例（14.1%），合并比例最高的呼吸道病毒为呼吸道合胞病毒。结论：儿童肺炎支原体肺炎呈全年散发，以夏秋季节多见，学龄前及学龄期儿童高发，同时还存在混合感染现象。

Abstract:

OBJECTIVE: To study the epidemiological characteristics of Mycoplasma pneumoniae pneumonia (MPP) in children, and to provide a basis for diagnosis and treatment. METHODS: The serum level of Mycoplasma pneumoniae antibody IgM (MP-IgM) was measured by enzyme-linked immunosorbent assay for 3156 hospitalized children with confirmed community acquired pneumonia from February 2011 to January 2012. The antigens of seven respiratory viruses were detected in the nasopharyngeal secretions of children with MPP. RESULTS: MP-IgM was detected in 427 of the 3156 patients, with a positive rate of 13.53%. The infection rate in female patients was significantly higher than in male patients (16.30% vs 11.70%; P<0.01). The MP-IgM detection rates were 3.6%, 12.5%, 19.2%, and 24.4% in children aged under 1 year, 1-3 years, 3-6 years and 6-14 years respectively (P<0.01), and the total MP-IgM detection rate in children aged under 3 years was significantly lower than in children over 3 years (P<0.01). The MP-IgM detection rate varied with the seasons and was significantly higher in summer and autumn than in winter and spring (19.18% vs 9.61%; P<0.01). Of the 427 MP-IgM-positive children, 60 (14.1%) were infected with respiratory viruses, and the highest proportion of which was respiratory syncytial virus. CONCLUSIONS: MPP is sporadic throughout the whole year, with a higher incidence in summer and autumn. MPP occurs mostly in preschool and school-age children, and there is mixed infection of MP and respiratory viruses.