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目的了解攀枝花地区儿童患急性呼吸道感染中非典型病原体在年龄、性别、季节及疾病种类的分布情况。方法选取2011年11月~2012年10月在我院儿科住院治疗的急性呼吸道感染患儿2397例,入院当天采集静脉血,应用间接免疫荧光法检测LP1、MP、QFR、CP、Ad、RSV、IVA、IVB和HPIVs的血清IgM抗体,并对阳性结果进行回顾性分析。结果 2397例患儿中,MP抗体检测阳性率最高(28.7%),其余依次为IVB(24.7%),IVA(12.3%),HPIVs(9.0%),Ad(5.0%),LP1(4.7%),RSV(2.8%)。QFR及CP检测阳性率极低。夏季肺炎支原体检出阳性率高,秋冬季IVB和MP检出阳性率高。MP和IVB在上呼吸道感染中检出阳性率高于下呼吸道感染。结论 MP、IVA、IVB和HPIVs是儿童急性呼吸道感染中非典型病原体的主要病原,夏季以MP感染为主,秋冬季以MP、IVB、IVA和HPIVs感染为主。主要致病原均以导致上呼吸道感染为主要临床表现。因此应重视非典型病原体的实验室检查,在不同季节,根据不同临床表现,进行合理诊治,选择适当的抗感染药物。
Objective To understand the distribution of atypical pathogens in children with acute respiratory infections in Panzhihua in terms of age, sex, season and disease types. Methods A total of 2397 children with acute respiratory tract infection admitted to our hospital from November 2011 to October 2012 were enrolled in this study. Venous blood was collected on the day of admission and the levels of LP1, MP, QFR, CP, Ad, RSV, IVA, IVB and HPIVs serum IgM antibodies, and the positive results were analyzed retrospectively. Results The positive rate of MP antibody in 2397 children was the highest (28.7%), followed by IVB (24.7%), IVA (12.3%), HPIVs , RSV (2.8%). QFR and CP test positive rate is very low. Mycoplasma pneumoniae summer positive rate was high, autumn and winter IVB and MP positive rate was detected. The positive rates of MP and IVB in upper respiratory tract infection were higher than those in lower respiratory tract infection. Conclusions MP, IVA, IVB and HPIVs are the main pathogens of atypical pathogens in children with acute respiratory infection. In summer, MP infection is the main pathogens. In autumn and winter, MP, IVB, IVA and HPIVs are the main pathogens. The main pathogens are caused by the upper respiratory tract infection as the main clinical manifestations. Therefore, attention should be paid to laboratory tests of atypical pathogens, and in different seasons, according to different clinical manifestations, reasonable diagnosis and treatment should be made and appropriate anti-infective drugs should be selected.