2018-2023年上海某医院肺炎支原体感染流行病学特征分析  

Characteristics of the mycoplasma pneumoniae epidemic in a shanghai hospital from 2018 to 2023

作　　者：王江 丁宁 王天凯[1] WANG Jiang;DING Ning;WANG Tiankai(Department of Laboratory Medicine,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201800,China)

机构地区：[1]上海交通大学医学院附属瑞金医院临床检验诊断中心,上海201800

出　　处：《检验医学与临床》2024年第S02期81-85,共5页Laboratory Medicine and Clinic

摘　　要：目的本研究旨在分析2018年至2023年该院北部院区主要因呼吸道疾病就诊患者中肺炎支原体(MP)患者的流行特征,并探讨实验室指标对MP感染者转阴时间的预测价值。方法收集2018年1月至2023年12月该院北部院区门急诊和住院部呼吸道感染患者共160471例。搜集到179例经回访明确转阴时间的病例,并统计患者C反应蛋白(CRP)、白细胞(WBC)、中性粒细胞(NE)、淋巴细胞(LY)和单核细胞(MO)等实验室指标。采用免疫胶体金方法检测全血MP免疫球蛋白M(MP-IgM)抗体,运用SPSS 25.0软件分析检测结果。结果160471例因呼吸道疾病就诊患者中MP-IgM抗体阳性患者13118例,阳性检出率8.17%;女性MP检出率高于男性MP检出率,差异有统计学意义(8.59%vs.7.79%,P<0.05);不同年龄组间MP感染情况存在差异,组间比较差异有统计学意义(χ^(2)=7851.975,P<0.05);2018年和2019年的MP检出率与2020年至2023年的MP检出率进行比较,差异有统计学意义(11.98%vs.7.43%,P<0.05);中性粒细胞(NE)升高对MP阳性患者的转阴时间具有预测价值[P<0.05,RR=1.047,95%CI(1.011~1.086)],当NE≥6.3×10^(9)时,NE每增加1×10^(9)个,转阴时间缩短1.047倍。结论MP在上海地区秋冬季易流行,新型冠状病毒感染流行前后的MP流行情况存在差异,女性较男性更易感染,3~13岁儿童之间更易传播,主要以发热和呼吸道症状为临床特征,患者NE数量对其转阴时间具有预测价值。Objective To analyze the epidemiological characteristics of patients infected mycoplasma pneumoniae in the hospital from 2018 to 2023,and investigate the predictive value of laboratory indicators in predicting clearance time of mycoplasma pneumoniae patients.Methods Totally,160471 patients from January 2018 to December 2023 in the outpatients,emergency cases and inpatients of the hospital were collected.179 cases with definite time of clearance were collected and C-reactive protein(CRP),white blood cells(WBC),neutrophils(NE),lymphocytes(LY),monocytes(MO)were counted.The mycoplasma pneumonia Immunoglobulin M(MP-IgM)antibody in whole blood was detected by immunocolloidal gold method,and the results were analyzed by SPSS 25.0.Results Among 160471 patients with respiratory diseases,13118 patients were positive for MP-IgM antibody,the positive rate was 8.17%.The positive rate of female was higher than that of male,and the difference was statistically significant(8.59%vs.7.79%,P<0.05).Mycoplasma pneumoniae infection was different among different age groups.The difference between groups was statistically significant(χ^(2)=7851.975,P<0.05).The detection rate of MP in 2018 and 2019 was compared with that from 2020 to 2023,and the difference was statistically significant(11.98%vs.7.43%,P<0.05).The increase of neutrophils(NE)had predictive value on the clear time of mycoplasma pneumoniae patients[P<0.05,RR=1.047,95%CI(1.011~1.086)].When NE≥6.3×10^(9),the clearance time was shortened by 1.047 times with an increase of 1×10^(9) NE.Conclusion Mycoplasma pneumoniae is more prevalent in autumn and winter in Shanghai,and the prevalence of MP before and after COVID-19 is different.Females are more susceptible to be infected than males,and transmission is more likely to be found in children aged 3 to 13.The clinical characteristics are mainly fever and respiratory symptoms,and the quantity of neutrophils(NE)had predictive value on the time of clearance in patients with mycoplasma pneumoniae.

关 键 词：肺炎支原体 流行特征 新型冠状病毒感染 中性粒细胞 上海市 

分 类 号：R563.1[医药卫生—呼吸系统] R181.3[医药卫生—内科学]