儿科重症监护室和普通病房小儿下呼吸道感染病原学分析  

Study on Pathogen of Lower Respiratory Tract Infection in Children in Pediatric Intensive Care Unit and Common Ward

作　　者：倪少娟[1] 陶春凤[1] 周华辉[1] 黄丽英[1] 李明艺[1] 

机构地区：[1]广西壮族自治区妇幼保健院,儿童医院检验科,南宁530003

出　　处：《中华妇幼临床医学杂志（电子版）》2012年第6期629-632,共4页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的探讨儿科重症监护室(PICU)和普通病房小儿下呼吸道感染病原谱的异同。方法选择2011年5月至7月于本院儿科住院的下呼吸道感染患儿397例为研究对象,其中男性患儿为240例(60.45%),女性为157例(39.55%)。将其按照患儿入住不同病房,分为普通病房组(n=320)和PICU组(n=77)。2组患儿的性别、年龄等比较,差异无统计学意义(P>0.05)(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意)。应用间接免疫荧光法(IFA),对所有下呼吸道感染患儿监测呼吸道合胞病毒(RSV),腺病毒(ADV),甲型流感病毒(IV-A),乙型流感病毒(IV-B),副流感病毒1,2,3型(PIV-1,2,3)等5种(共7型)病毒的IgM抗体,以及肺炎支原体(MP),嗜肺军团菌Ⅰ型(LP1),肺炎衣原体(CPn)、Q热立克次体(QFR)等4种非典型病原体的IgM抗体。结果 PICU组(n=77)患儿检出病原呈阳性为43例,阳性率为55.84%,非典型病原体检出率为68.83%(53/77),病毒检出率为19.48%(15/77),混合感染占阳性患儿的51.16%(22/43)。普通病房组(n=320)患儿检出病原呈阳性者为115例,阳性率为35.94%,非典型病原体阳性率为42.5%(136/320),病毒阳性率为16.56%(53/320),混合感染占呈阳性患儿的50.43%(58/115)。MP为2组患儿感染率最高的病原体(41.56%vs.24.69%)。非典型病原体阳性率,2组比较,差异有统计学意义(P<0.01),其中MP阳性率比较,差异有统计学意义(P<0.01);病毒阳性率比较,差异无统计学意义(P>0.05)。结论非典型病原体是儿科下呼吸道感染的主要病原,MP为最常见病原,感染以PICU患儿多见。儿科下呼吸道混合感染较为常见,以MP+LP1双重感染最为多见。Objective To investigate the pathogen of low respiratory tract infection in children in pediatric intensive care unit （PICU） and common ward. Methods From May to July, 2011, a total of 397 cases （240 boys and 157 girls） with low respiratory tract infection were included into this study. They were divided into two groups, PICU group （n=77） and common ward group （n=320）. There had no significant differences in age and gender between two groups （P0.05）. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Maternity and Child Care Hospital of Guangxi Zhuang Autonomous Region. Informed consent was obtained from all participates′ parents. The samples were collected from two groups for the test of indirect immunofluorescence assay （FIA）. The following items were detected, IgM antibody of 5 viruses （7 types）, including respiratory syncytial virus （RSV）, adenovirus（ADV）, influenza virus type A （IV-A）, influenza virus type B （IV-B）, parainfluenza virus type （PIV-1, 2, 3） and 4 atypical pathogens, including Mycoplasma pneumonia （MP）, Legionella pneumophila 1 （LP 1）, Chlamydia pneumonia （CPn）, Q fever rickettsia （QFR）. Results Among PICU group （n=77）, positive rate of pathogen was 55.84% （43/77）, of which, atypical pathogens detected rate was 68.83% （53/77）, and virus detected rate was 19.48% （15/77）, mixed infection were detected in 22 of 43 positive infectors （51.16%）. Among common ward group （n=320）, positive rate of pathogen was 35.94% （115/320）, of which, atypical pathogens detected rate was 42.5% （136/320）, and virus detected rate was 1656% （53/320）, mixed infection were detected in 58 of 115 positive infectors （50.43%）. MP was the most common pathogen with higher positive rate of two groups （41.56% vs. 24.69%）.Conclusions Atypical pathogens was the mostly pathogen of lower respiratory tract infection in pediatric clinics, especially PICU children. Further more, dual

关 键 词：呼吸道感染 非典型病原体 病毒 儿科重症监护室 普通病房 

分 类 号：R725.1[医药卫生—儿科]