11439例发热患者呼吸道非典型病原体感染情况分析  

Analysis of respiratory atypical pathogen infection in 11439 febrile patients

作　　者：陈磊[1] 李航 CHEN Lei;LI Hang(Department of Laboratory,Kaifeng Center for Disease Control and Prevention,Kaifeng,Henan 475000,China;Department of Laboratory,Kaifeng Central Hospital,Kaifeng,Henan 475000,China)

机构地区：[1]开封市疾病预防控制中心检验科,河南开封475000 [2]开封市中心医院检验科,河南开封475000

出　　处：《医药论坛杂志》2024年第7期724-729,共6页Journal of Medical Forum

基　　金：开封市科技攻关计划(1903039)。

摘　　要：目的了解开封地区发热呼吸道症状患者血清非典型病原体IgM抗体检出率及感染情况,分析呼吸道非典型病原体流行病学特征,为早期呼吸道感染疾病预防和临床合理使用抗感染药物提供参考依据。方法采集2019年1月-2020年12月开封市中心医院门诊和住院急性呼吸道感染患者的血清标本,采用间接免疫荧光法定性检测嗜军团菌(LP)、肺炎支原体(MP)、肺炎衣原体(CP)、腺病毒(ADV)、呼吸道合胞病毒(RSV)、甲型流感病毒(INFA)、乙型流感病毒(INFB)、副流感病毒(PIVS)和Q热立克次体(COX)九种呼吸道非典型病原体血清IgM抗体,采用SPSS 21.0软件进行统计分析。结果收集11439例呼吸道感染患者血清样本,呼吸道感染非典型病原体IgM抗体检测(以下简称九联检)阳性共计5026例,阳性率为43.9%,所得抗体阳性率之间结果比较χ^(2)=4419.5,P=0.00。单一种抗体阳性3472例,占69.1%。两种抗体阳性1523例,占30.3%。三种及以上多重抗体阳性31例,占0.6%,结果比较χ^(2)=5331.1,P=0.00。2019年阳性率42.7%,2020年阳性率45.1%,两年阳性率差异有统计学意义(χ^(2)=6.37,P=0.012)。不同年龄分组九联检阳性率比较,儿童组阳性率49.4%,青年组31.0%,中年组阳性率32.8%,老年组阳性率42.8%,阳性率比较(χ^(2)=130.7,P=0.00),差异有统计学意义。九种病原体抗体在不同年龄组占比最高的分别为:老年组嗜肺军团菌占比48.3%,Q热立克次氏体占比91.7%;青年组肺炎衣原体占比38.2%;儿童组中肺炎支原体阳性占比55.6%,腺病毒占比58.9%,呼吸道合胞病毒占比73.1%,甲型流感病毒占比39.4%,乙型流感病毒占比43.7%和副流感病毒占比40.1%。结论2019年和2020年九种呼吸道病原体抗体IgM阳性率之间有差别,主要致病非典型病原体为肺炎支原体、甲型和乙型流感病毒,不同年龄组病原体分类中儿童感染阳性率最高,以肺炎支原体为主,老年人以流感病毒为主,中青年感染阳性�Objective To understand the detection rate and infection status of serum atypical pathogen IgM antibodies in patients with fever and respiratory symptoms in Kaifeng area,analyze the epidemiological characteristics of respiratory atypical pathogens,and provide reference basis for early prevention of respiratory infections and rational use of anti infective drugs in clinical practice.Methods Serum samples from outpatient and inpatient patients with acute respiratory infections at Kaifeng Central Hospital from January 2019 to December 2020 were collected.Indirect immunofluorescence assay was used to detect Legionella(LP),Mycoplasma pneumoniae(MP),Chlamydia pneumoniae(CP),adenovirus(ADV),respiratory syncytial virus(RSV),influenza A virus(INFA),influenza B virus(INFB)PIVS and COX,the serum IgM antibodies against nine atypical respiratory pathogens.SPSS 21.0 software was used to statistically analyzed.As a result,serum samples from 11439 patients with respiratory tract infections were collected.A total of 5026 cases were tested positive for IgM antibodies against atypical pathogens in respiratory tract infections(hereinafter referred to as the nine test),with a positive rate of 43.9%.The comparison of the positive rates of the obtained antibodies was χ^(2)=4419.5,P=0.00.3472 cases were positive for a single antibody,accounting for 69.1%.1523 cases were positive for two types of antibodies,accounting for 30.3%.31 cases were positive for three or more types of multiple antibodies,accounting for 0.6%.The comparison of the results was χ^(2)=5331.1,P=0.00.The positive rate in 2019 was 42.7%,and in 2020 it was 45.1%.The difference in positive rates between the two years was statistically significant(χ^(2)=6.37,P=0.012).Comparison of the positivity rates of nine tests in different age groups:49.4% in the children's group,31.0% in the youth group,32.8% in the middle-aged group,and 42.8% in the elderly group.Comparison of positivity rates(χ^(2)=130.7,P=0.00),the difference was statistically significant.The highest proportio

关 键 词：呼吸道感染 血清IgM抗体 非典型病原体 

分 类 号：R446[医药卫生—诊断学]