门急诊不同年龄段肺炎支原体抗体阳性儿童特征分析  

Clinical characteristics of pediatric patients with mycoplasma pneumonia antibody positive in clinic under different age groups

作　　者：戴淑芝[1] 王溦雅 王莹[1] 张文 马丽娟[1] Dai Shuzhi;Wang Weiya;Wang Ying;Zhang Wen;Ma Lijuan(Department of Clinical Laboratory,Children's Hospital,Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院检验中心,北京100020

出　　处：《中国医学前沿杂志（电子版）》2022年第5期42-46,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的分析门急诊不同年龄段肺炎支原体(mycoplasma pneumoniae,MP)-IgM抗体阳性儿童的临床特征。方法收集2016年3月至2021年2月首都儿科研究所附属儿童医院门急诊70259例MP-IgM抗体阳性儿童资料,按年龄段分为<1岁组(婴儿组)、1~<3岁组(幼儿组)、3~5岁组(学龄前组)、6~14岁组(学龄组),分析不同年龄段患儿性别、发病季节、主要临床症状、呼吸道相关疾病、肺外症状等方面差异。结果70259例MP-IgM抗体阳性儿童年龄分布:学龄前组(43.15%)>学龄组(29.80%)>幼儿组(22.92%)>婴儿组(4.13%)。同期检测患儿中女性MP-IgM抗体阳性率(15.21%)高于男性(13.57%),存在统计学差异(χ^(2)=267.065,P<0.01)。2016—2020年先后出现两次发病高峰期:2016年冬季至2017年夏季,持续9个月。2018年秋季至2019年夏季,持续12个月,婴儿组未显示发病高峰。各年龄段常见临床表现为单纯呼吸道症状(87.47%,年龄越大发生率越高),其次为呼吸道伴消化道症状(5.41%,年龄越小发生率越高)、发热伴呼吸道症状(4.22%)和单纯发热(1.67%,婴幼儿更容易发热)。各年龄段常见呼吸道疾病为上呼吸道感染(34.48%)、肺炎(13.91%)、支气管炎(10.15%)、鼻炎或鼻窦炎(9.74%)、扁桃体炎(5.05%)、喘息性支气管炎(3.62%)、咽喉炎(2.98%)和哮喘(2.73%),其中学龄组上呼吸道感染发生率相对较低,肺炎则高发,鼻(窦)炎和扁桃体炎年龄越大发生率越高,喘息性支气管炎和支气管炎年龄越小发生率越高,咽喉炎和哮喘均不具有年龄差异。肺外症状以消化道症状为主(6.64%),其次为皮肤损伤(1.64%)和血液系统症状(1.40%),婴幼儿更容易出现肺外症状。结论MP感染与年龄有关,以1~14岁儿童高发,整体阳性率女性高于男性。2016—2020年分别出现两次MP感染高峰,婴儿组无高峰。门急诊MP-IgM抗体阳性患儿主要以上呼吸道感染、肺炎、支气管炎和鼻(窦)炎、扁桃体炎等疾病为主,不同年龄间差异Objective To analyze the clinical characteristics of pediatric patients with mycoplasma pneumoniae(MP)-IgM antibody positive in clinic under different age groups.Method A total of 70259 pediatric patients with positive MP-IgM antibody in Children􀆳s Hospital,Capital Institute of Pediatrics from March of 2016 to February of 2021 were divided into four groups according to their age:<1 year old(infant group),1-<3 years old(toddler group),3-5 years old(preschool group)and 6-14 years old(school-age group).Sex,seasons of onset,clinical symptoms,respiratory tract related diseases,extrapulmonary symptoms were compared between different groups.Result Among the 70259 samples,positive rate was 43.15%in preschool group,29.80%in school-age group,22.92%in toddler group and 4.13%in infant group.MP antibody positive rate in girl group was significant higher than boy group(15.21%vs.13.57%,χ^(2)=267.065,P<0.01).Two waves of MP incidence was shown from winter of 2016 to summer of 2017 and from autumn of 2018 to summer of 2019,lasted 9 months and 12 months respectively in all ages except infant groups.The common clinical manifestations of all ages were simple respiratory symptoms(87.47%),respiratory symptoms with gastrointestinal symptoms(5.41%),fever with respiratory symptoms(4.22%)and simple fever(1.67%).The common respiratory diseases of all ages were upper respiratory tract infection(UTRI,34.48%),pneumonia(13.91%),bronchitis(10.15%),rhinitis or sinusitis(9.74%),tonsillitis(5.05%),asthmatic bronchitis(3.62%),pharyngitis(2.98%)and asthma(2.73%).Compared with other groups,the UTRI was lower in school-age group while pneumonia was higher.Rhinosinusitis and tonsillitis incidence increased with age,while asthmatic bronchitis and bronchitis decreased with age.The incidence of pharyngitis and asthma did not show difference between groups.The most common extrapulmonary syndrome was gastrointestinal symptoms(6.64%),followed by skin damage(1.64%)and hematologic symptoms(1.40%).Infants and toddlers had higher incidence of extrapulmonary

关 键 词：肺炎支原体 高发 年龄 儿童 上呼吸道感染 肺外症状 

分 类 号：R725.6[医药卫生—儿科]