儿童急性呼吸道肺炎支原体感染流行特点及与气候因素的关系探讨

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目的探讨儿童急性呼吸道肺炎支原体(mycoplasma pneumoniae,MP)感染流行特点及与气候因素的关系。方法选择2006年1月—2009年12月因急性呼吸道MP感染住院的患儿8 368例,运用实时聚合酶链式反应(polymerase chain reaction,PCR)检测鼻咽部分泌物中MP基因片段,采用定量酶联免疫吸附剂测定(enzyme linked immunosorbent assay,ELISA)检测血清中MP特异性抗体,同时收集2006—2009年苏州地区有关气象资料。计数资料组间率的比较采用χ2检验,各气象因素间的交互作用,自变量的筛选,则采用逐步回归分析,P<0.05为差异有统计学意义。结果 MP感染总阳性率为32.9%,2006—2009年分别为25.6%、29.0%、36.7%、40.0%,年度之间比较差异有统计学意义(χ2=127.96,P<0.05)。春、夏、秋、冬季分别为31.8%、38.8%、37.4%、23.3%,不同季节MP感染阳性率比较差异有统计学意义(χ2=139.77,P<0.05)。MP感染好发于每年的5—11月,即夏秋季节,流行月份(2009年11月)可高达55.4%。MP感染与月平均气温呈正相关(r=0.529,P<0.05),与其他气候因素无相关性。结论 MP是儿童急性呼吸道感染的主要病原之一,不同季节感染率不同,气候因素尤其是温度,对MP的流行起着重要作用。 Objective To investigate the prevalence of acute respiratory Mycoplasma pneumoniae (MP) infection and its relationship with climatic factors in children. Methods From January 2006 to December 2009, 8 368 children hospitalized with acute respiratory infection were enrolled in this study. MP gene fragments in nasopharyngeal secretions were detected by real-time polymerase chain reaction (PCR) Serum MP-specific antibodies were detected by enzyme-linked immunosorbent assay (ELISA), and relevant meteorological data of Suzhou area from 2006 to 2009 were also collected. Chi-square test was used to compare the data rates between groups. The interaction between meteorological factors and the screening of independent variables were analyzed by stepwise regression analysis. P <0.05 was considered statistically significant. Results The total positive rate of MP infection was 32.9%. From 2006 to 2009, they were 25.6%, 29.0%, 36.7% and 40.0% respectively. There was significant difference between years (χ2 = 127.96, P <0.05). The positive rates of MP infection in different seasons were 31.8%, 38.8%, 37.4% and 23.3% respectively in spring, summer, autumn and winter (χ2 = 139.77, P <0.05). MP infection occurs in May-November each year, that is, summer and autumn, the popular month (November 2009) up to 55.4%. MP infection was positively correlated with monthly mean temperature (r = 0.529, P <0.05), but not with other climatic factors. Conclusion MP is one of the major pathogens of acute respiratory infections in children. Different infection rates in different seasons, and climatic factors, especially temperature, play an important role in the epidemic of MP.
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