2023—2024年兰州市某三甲医院6种呼吸道病原体流行特征分析  

Epidemiological characteristics of six common respiratory patho gens in a tertiary hospital in Lanzhou from 2023 to 2024

作　　者：朱莉莎 李德顺 李娜 包海荣[2] ZHU Lisha;LI Deshun;LI Na;BAO Hairong(The First Clinical Medical School,Lanzhou University,Lanzhou 730000,China;Department of Pulmonary and Critical Care Medicine,The First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]兰州大学第一医院呼吸与危重症医学科,甘肃兰州730000

出　　处：《兰州大学学报(医学版)》2025年第1期34-39,45,共7页Journal of Lanzhou University(Medical Sciences)

基　　金：甘肃省科技计划项目-创新基地和人才计划资助项目(20JR10FA666)。

摘　　要：目的分析2023—2024年兰州市6种呼吸道病原体病原谱及流行特征,为急性呼吸道感染防治工作提供参考。方法收集2023年3月—2024年12月兰州大学第一医院门急诊及住院的急性呼吸道感染患者14402例,采集患者的咽拭子,运用实时荧光定量PCR法检测6种常见呼吸道病原体即甲型流感病毒(FluA)、乙型流感病毒(FluB)、鼻病毒(HRV)、呼吸道合胞病毒(RSV)、腺病毒(ADV)和肺炎支原体(MP)的核酸,分析其分布特征。结果6种呼吸道病原体总体阳性率为50.5%,其中单一感染检出率为46.9%,混合感染检出率为3.7%。检出率排名前3位的病原体依次是MP(21.3%)、FluA(10.8%)、HRV(10.4%)。病原体总体阳性率在性别(χ^(2)=13.396,P<0.05)、年龄(χ^(2)=2829.124,P<0.05)及季节(χ^(2)=408.629,P<0.05)间差异有统计学意义。其中,儿童FluB、HRV、RSV、ADV和MP的阳性率均高于中青年和老年患者(P均<0.0167);中青年FluA的阳性率高于老年患者(P<0.0167)。HRV在秋季的阳性率高于其他三季(P均<0.0083),而FluA、FluB、RSV、ADV主要在冬季高发(P均<0.0083)。结论预测FluA高流行态势可能延续至2025年5月底,MP流行强度将逐步减弱,HRV流行趋势相对稳定。未来需加强病原体监测,重点关注儿童等易感人群,并针对不同人群和季节采取有针对性的防控措施。Objective To examine the pathogen spectrum and epidemiological traits of six common respiratory pathogens in Lanzhou from 2023 to 2024,thereby offering guidance for the prevention and treatment of acute respiratory infection.Methods From March 2023 to December 2024,14402 patients with acute respiratory infection were collected from the outpatient,emergency and inpatient departments of the First Hospital of Lanzhou University.Their throat swabs were collected and tested for nucleic acids of six common respiratory pathogens,namely influenza A virus(FluA),influenza B virus(FluB),rhinovirus(HRV),respiratory syncytial virus(RSV),adenovirus(ADV),and mycoplasma pneumoniae(MP),using real-time quantitative PCR.Their distribution characteristics were analyzed.Results There were 14402 case samples examined in all.The over-all positive rate of the six respiratory pathogens was 50.5%,of which the detection rate of single infection was 46.9%and that of mixed infection 3.7%.The top three pathogens in terms of detection rate were MP(21.3%),FluA(10.8%),and HRV(10.4%).The overall positive rate of pathogens exhibited significant differences among gender(χ^(2)=13.396,P<0.05),age groups(χ^(2)=2829.124,P<0.05),and seasons(χ^(2)=408.629,P<0.05).Specifically,the positive rates for FluB,HRV,RSV,ADV,and MP were higher in children compared to middle-aged and elderly patients(all P<0.0167).Conversely,the detection rate of FluA was higher in young and middle-aged patients than in elderly patients(P<0.0167).Additionally,the positive rate of HRV was higher in autumn compared to the other three seasons(all P<0.0083),while FluA,FluB,RSV and ADV predominantly circulated in winter(all P<0.0083).Conclusions It is predicted that the high epidemic trend of fluA may continue until the end of May 2025,then the epidemic intensity of MP will gradually weaken,and the epidemic trend of HRV will be relatively stable.In the future,we should strengthen pathogen monitoring,pay attention to children and other susceptible populations,and take targeted prevent

关 键 词：急性呼吸道感染 病原体 流行特征 甲型流感病毒 乙型流感病毒 鼻病毒 呼吸道合胞病毒 腺病毒 肺炎支原体 

分 类 号：R372[医药卫生—病原生物学] R56[医药卫生—基础医学]