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目的调查分析莱芜市儿童社区获得性肺炎(community acquired pneumonia,CAP)中肺炎支原体(mycoplasma pneumoniae,MP)的感染情况,为临床防治提供依据。方法选择2010年1月—2012年12月确诊为CAP的患儿2 926例,利用被动凝集法测定患儿血清中的MP-IgM,MP-IgM测定阳性者诊断为肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)。同时详细记录患儿的性别、发病年龄、生活环境、发病时间及肺部X线表现等情况。计数资料采用χ2检验,P<0.05为差异有统计学意义。结果 CAP患儿中MP感染率以2012年感染率(35.1%)最高,与2010、2011年比较差异有统计学意义(P<0.05)。MP感染一年四季均可发生,2010年及2011年感染率较高的季节为第一、第四季度,而2012年各季度感染率均高于2010年度及2011年度,其中以第二季度感染率最高。综合2010—2012年平均以第一季度发感染率(30.5%)最高。4~6岁、7~9岁的MP感染率(46.6%、45.4%)明显高于其他年龄段,差异有统计学意义(P<0.05)。男性的MP感染率为24.2%,女性的MP感染率为26.2%,差别无统计学意义(P>0.05)。大叶性肺炎患儿中288例MP-IgM检测结果阳性,阳性率最高,为62.9%,与间质性肺炎、支气管肺炎比较,差异均有统计学意义(均P<0.05)。居住地在城市的患儿MP-IgM阳性率(32.3%)明显高于居住地在农村的患儿(21.0%),比较差异有统计学意义(P<0.05)。结论儿童MP感染率随流行年份及季节不同而不同,高发年龄阶段是4~6岁和7~9岁,肺部X线表现为大叶性肺炎者一半以上由MP感染所致,城市患儿中MP感染率高于农村患儿。了解本地区MP感染流行特点,在病程初期即可给予经验性诊断及治疗,以缩短病程及减少用药,提高疗效。
Objective To investigate the prevalence of mycoplasma pneumoniae (MP) infection in children with community acquired pneumonia (CAP) in Laiwu City and provide evidence for clinical prevention and treatment. Methods A total of 2 926 children diagnosed with CAP from January 2010 to December 2012 were selected. Serum MP-IgM was measured by passive agglutination and positive for MP-IgM was diagnosed as mycoplasma pneumoniae pneumonia , MPP). At the same time detailed records of children’s gender, age of onset, living environment, onset and lung X-ray performance. Count data using χ2 test, P <0.05 for the difference was statistically significant. Results The prevalence of MP infection in CAP children was the highest in 2012 (35.1%), which was significantly different from that in 2010 and 2011 (P <0.05). MP infection can occur throughout the year, the highest infection rates in 2010 and 2011 are the first and fourth quarters, while the infection rates in all quarters in 2012 are higher than in 2010 and 2011, of which the second quarter The highest rate. In 2010-2012, the average incidence of infection in the first quarter (30.5%) was the highest. The infection rate of MP between 4 ~ 6 years old and 7 ~ 9 years old was significantly higher than that of other age groups (46.6%, 45.4%) (P <0.05). The prevalence of MP was 24.2% in males and 26.2% in females, the difference was not statistically significant (P> 0.05). The results of MP-IgM in 288 children with lobar pneumonia were positive, with the highest positive rate of 62.9%. Compared with interstitial pneumonia and bronchial pneumonia, the difference was statistically significant (both P <0.05). The positive rate of MP-IgM in children living in urban areas was significantly higher than that of children living in rural areas (32.3%) (21.0%), with significant difference (P <0.05). Conclusions The prevalence of MP infection in children varies with the epidemic year and season. The high-incidence age group is 4 to 6 years old and 7 to 9 years old. More than half of the patients with lobar pneumonitis are caused by MP infection. In the MP infection rate in rural children. To understand the epidemic of MP infection in the region, the initial course of the disease can be given to the empirical diagnosis and treatment to reduce the duration and reduce medication, improve efficacy.