以呼吸道症状首次就诊者常见病原体流行情况及不同方法检测病原体的效能分析  

Analysis of the prevalence of common pathogens in first-time patients with respiratory symptoms and the efficacy of different methods for detecting pathogens

作　　者：于洋 林枫 张磊[1] 李卓敏 王新宇 谭延国[1] YU Yang;LIN Feng;ZHANG Lei;LI Zhuomin;WANG Xinyu;TAN Yanguo(Department of Clinical Laboratory,Fuxing Hospital,Capital Medical University,Beijing 100053,China;Department of Laboratory Medicine,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属复兴医院检验科,北京100038 [2]首都医科大学医学检验系,北京100038

出　　处：《国际检验医学杂志》2025年第7期773-779,共7页International Journal of Laboratory Medicine

基　　金：首都医科大学教育教学改革研究课题项目(2023JYY266)。

摘　　要：目的探讨9种呼吸道病原体在2023年3月至2024年2月的流行情况,以及各种方法对病原体的检测效能。方法回顾性分析于2023年3月至2024年2月首都医科大学附属复兴医院以呼吸道症状首次就诊者38948例的9种病原体的检出情况,以及核酸、抗原、抗体等方法的检测效能。结果(1)38948例患者中,共8345例(21.43%)至少检出1种病原体,其中仅检出1种病原体的为8158例(20.95%),两种及以上的为187例(2.29%,187/8158);检出率前3位为新型冠状病毒(SARS-CoV-2,20.37%)、肺炎支原体(MP,15.58%)、甲型流感病毒(IVA,10.79%)。(2)至少检出9种病原体中的一种的患者中,秋季检出率为24.94%,春季检出率为21.45%、夏季检出率为18.54%、冬季检出率为19.22%,四季检出率比较差异有统计学意义(P<0.001)。(3)除SARS-CoV-2春季(51.24%)、夏季(37.31%)检出率相对较高,乙型流感病毒(IVB)冬季(11.28%)检出率最高外,其余病原体检出率均于秋季最高。(4)儿童组(31.83%)、青年组(12.48%)、中年组(10.70%)和老年组(12.43%)总检出率比较差异有统计学意义(P<0.001);MP、IVA、IVB、合胞病毒、肺炎衣原体、腺病毒、副流感病毒1型等7种病原体均在儿童中检出率最高,各年龄组间比较差异有统计学意义(P<0.05);SARS-CoV-2在儿童组中检出率(3.45%)低于其他年龄组患者(30.90%、29.09%、32.16%,P<0.001);副流感病毒3型(HPIV-3)在不同年龄组间比较差异无统计学意义(P=0.478)。(5)男、女之间总检出率比较差异无统计学意义(P>0.05)。但女性MP、肺炎衣原体(CP)检出率均高于男性(P<0.05),而男性IVA检出率略高于女性(P=0.014);其他6种病原体检出率在男女之间比较差异无统计学意义(P>0.05)。(6)MP抗原检测检出率低于MP核酸检测(P<0.001);MP抗体检测的检出率高于MP核酸检测(P<0.001);MP抗体检测的检出率随自首发症状到就诊时间延长明显增高(P<0.001)。(7)IVA、IVB、呼吸道合胞病毒(RSV)、腺病毒(ADV)4种Objective To explore the prevalence of 9 respiratory pathogens from March 2023 to February 2024,as well as the detection efficiency of various methods for pathogens.Methods A retrospective analysis was conducted on the detection of 9 pathogens in 38 948 patients who first presented with respiratory symptoms from March 2023 to February 2024,as well as the detection efficacy of nucleic acid,antigen,antibody and other methods.Results Firstly,among 38 948 patients,a total of 8 345 cases(21.43%) were detected with at least one pathogen,of which 8 158 cases(20.95%) were detected with only one pathogen,and 187 cases(2.29%,187/8 158) were detected with two or more pathogens.The top three detection rates were SARS-CoV-2(20.37%),mycoplasma pneumoniae(MP,15.58%) and influenza A virus(IVA,10.79%).Secondly,among patients who detected at least one of the nine pathogens,the detection rate was 24.94% in autumn,21.45% in spring,18.54% in summer,and 19.22% in winter,and the difference in detection rates between the four seasons was statistically significant(P<0.001).Thirdly,except for the relatively high detection rates of SARS-CoV-2 in spring(51.24%) and summer(37.31%),and the highest detection rate of IVB in winter(11.28%),the detection rates of other pathogens were highest in autumn.Fourthly,there was a statistically significant difference in the total detection rates among the children group(31.83%),the youth group(12.48%),the middle-aged group(10.70%),and the elderly group(12.43%)(P<0.001).The detection rates of 7 pathogens,including MP,IVA,Influenza B virus(IVB),syncytial virus,CP,adenovirus,and parainfluenza virus type 1,were highest in children,and there was a statistically significant difference in comparison between different age groups(P<0.05).The detection rate of SARS-CoV-2 in the children group(3.45%) was lower than that in other age groups(30.90%,29.09%,32.16%,P<0.001).There was no statistically significant difference in HPIV-3 between different age groups(P=0.478).Fifthly,there was no significant difference in over

关 键 词：呼吸道病原体 检出率 核酸检测 抗原检测 抗体检测 

分 类 号：R446.5[医药卫生—诊断学]