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目的描述不同感染类型的儿童社区获得性肺炎(CAP)在不同性别、年龄、季节间的分布,为儿童CAP正确诊断提供参考依据以及制定合理用药规范奠定基础。方法共纳入1 155例合格儿童CAP病例,采用间接免疫荧光法(IFA)、被动凝集法、酶联免疫吸附试验(ELISA)法、胶体金法和细菌培养法联合检测常见呼吸道病原体。根据致病微生物类型将儿童CAP分为肺炎支(衣)原体肺炎、病毒性肺炎、细菌性肺炎、混合感染性肺炎和不明原因肺炎。结果研究对象中男670例(58.0%),女485例(42.0%)。患儿年龄为1月~14岁,平均年龄为(3.14±2.78)岁。病原学检测阳性数为758(65.6%)。其中,肺炎支(衣)原体肺炎占56.1%,病毒性肺炎占14.9%,细菌性肺炎占12.0%,混合感染性肺炎占17.0%。肺炎支(衣)原体肺炎在2~5岁组最高(49.9%),而病毒性肺炎和细菌性肺炎均以1岁以下患儿居多;肺炎支(衣)原体肺炎感染率夏秋季高于春冬季(P<0.05),而病毒性和细菌性肺炎均是春冬季高于夏秋季(P<0.05);肺炎支(衣)原体肺炎在城市儿童中更常见,而病毒性和细菌性肺炎则无明显城乡分布差异(P<0.05)。结论肺炎支(衣)原体肺炎在儿童CAP构成中占主要;不同感染类型的儿童CAP流行特征存在差异。
Objective To describe the distribution of community acquired pneumonia (CAP) among children of different types of infection in different sexes, ages and seasons, to provide a reference for the correct diagnosis of CAP in children and to lay the foundation for the formulation of rational drug use rules. Methods A total of 1 155 cases of children with CAP were enrolled in this study. Common respiratory pathogens were detected by indirect immunofluorescence (IFA), passive agglutination test, enzyme-linked immunosorbent assay (ELISA), colloidal gold assay and bacterial culture. According to the type of pathogenic microorganisms in children CAP is divided into pneumonia, bronchial pneumonia, bacterial pneumonia, mixed infectious pneumonia and unexplained pneumonia. Results The study included 670 males (58.0%) and 485 females (42.0%). Children aged from January to 14 years, mean age (3.14 ± 2.78) years old. The positive number of etiological tests was 758 (65.6%). Among them, pneumonia (pneumonia) (pneumonia) accounted for 56.1%, viral pneumonia accounted for 14.9%, bacterial pneumonia accounted for 12.0%, mixed infectious pneumonia accounted for 17.0%. Pneumonia (Pneumonia) (Pneumocystis) pneumonia was the highest (49.9%) in the age group of 2 to 5 years, while viral pneumonia and bacterial pneumonia were mostly children under 1 year of age. Pneumonia (Pneumoniae) In spring and winter (P <0.05), viral and bacterial pneumonia were higher in spring and spring than in summer and autumn (P <0.05). Pneumoniae (Pneumocystis) pneumonia was more common in urban children, whereas viral and bacterial There was no significant difference between urban and rural areas in sex pneumonia (P <0.05). Conclusions Pneumoniae (pneumoniae) (Pneumocystis) pneumonia predominate in the constitution of CAP in children; there are differences in the prevalence of CAP in children of different types of infection.