不同感染类型的儿童社区获得性肺炎流行病学特征研究  

An epidemiological study of different types of infection among children with community-acquired pneumonia

作　　者：许姜姜[1] 舒林华[1] 钟海琴[1] 蒋鲲[1] 孙超[1] 胡祎静 

机构地区：[1]上海市儿童医院,上海交通大学附属儿童医院,上海200062

出　　处：《现代预防医学》2016年第16期2909-2912,共4页Modern Preventive Medicine

基　　金：第四轮公共卫生三年行动计划重点学科建设项目(项目编号:15GWZK0103)

摘　　要：目的描述不同感染类型的儿童社区获得性肺炎（CAP）在不同性别、年龄、季节间的分布,为儿童CAP正确诊断提供参考依据以及制定合理用药规范奠定基础。方法共纳入1 155例合格儿童CAP病例,采用间接免疫荧光法（IFA）、被动凝集法、酶联免疫吸附试验（ELISA）法、胶体金法和细菌培养法联合检测常见呼吸道病原体。根据致病微生物类型将儿童CAP分为肺炎支（衣）原体肺炎、病毒性肺炎、细菌性肺炎、混合感染性肺炎和不明原因肺炎。结果研究对象中男670例（58.0%）,女485例（42.0%）。患儿年龄为1月~14岁,平均年龄为（3.14±2.78）岁。病原学检测阳性数为758（65.6%）。其中,肺炎支（衣）原体肺炎占56.1%,病毒性肺炎占14.9%,细菌性肺炎占12.0%,混合感染性肺炎占17.0%。肺炎支（衣）原体肺炎在2~5岁组最高（49.9%）,而病毒性肺炎和细菌性肺炎均以1岁以下患儿居多;肺炎支（衣）原体肺炎感染率夏秋季高于春冬季（P〈0.05）,而病毒性和细菌性肺炎均是春冬季高于夏秋季（P〈0.05）;肺炎支（衣）原体肺炎在城市儿童中更常见,而病毒性和细菌性肺炎则无明显城乡分布差异（P〈0.05）。结论肺炎支（衣）原体肺炎在儿童CAP构成中占主要;不同感染类型的儿童CAP流行特征存在差异。Objective This work was to study the distribution of different infections among children with community-acquired pneumonia（CAP） with gender, age and season, and study the clinical characteristics as well, so as to provide a reference for CAP correct diagnosis and lay the foundation for the development of rational drug use. Methods A total of 1155 eligible children with CAP were enrolled, among which 670（58.0%） were boys and 485（42.0%）were girls. Age range was 1month-14 years, and mean age was（3.14 ±2.78） years. Common respiratory pathogenic microorganisms were determined by using indirect Immunofluorescence Assay（IFA）, Particle Agglutination Test and Enzyme-linked Immunosorbent Assay（ELISA）,Colloidal gold method and Bacterial culture. By the pathogenic microorganisms, children were divided into five groups： MP/CP pneumonia, viral pneumonia, bacterial pneumonia, pneumonia of mixed infections and pneumonia of unknown causes.Results 758（65.6%）specimens were positive. The percentage of MP/CP pneumonia, viral pneumonia, bacterial pneumonia and pneumonia of mixed infections was 56.1%, 14.9%, 12.0% and 17.0%, respectively. MP/CP pneumonia was the most common among children aged 2-5 years（49.9%）, while viral pneumonia and bacterial pneumonia were both the most common among children younger than 1 years old. The incidence of MP/CP pneumonia was significantly higher in summer and autumn than in winter and spring（P〈0.05）, while viral pneumonia and bacterial pneumonia were the opposite（P〈0.05）.MP/CP pneumonia was more common in urban children（P 0.05）, while the incidence of viral and bacterial pneumonia showed no significant difference between urban and rural children. Conclusion MP/CP pneumonia is the most common among children with CAP. The epidemiological characteristics is different among children with CAP caused by different pathogenic microorganisms.

关 键 词：社区获得性肺炎 儿童 致病微生物 流行病学 

分 类 号：R183.3[医药卫生—流行病学]