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上海宝山区九项呼吸道病原体IgM抗体检出率分析
作者:刘灵燕  钟政荣  王萍  许蓓妮  喻成飞  郭竹英 
单位:上海交通大学医学院附属第九人民医院 检验科, 上海 201999
关键词:呼吸道感染 病原体 间接免疫荧光法 
分类号:R446.5
出版年·卷·期(页码):2020·39·第七期(836-840)
摘要:

目的:分析上海宝山区9项呼吸道病原体IgM抗体的检出情况。方法:收集我院2017年1 713例呼吸道感染患者的血清标本,采用间接免疫荧光法检测嗜肺军团菌血清1型(Lp1)、肺炎支原体(MP)、Q热立克次体(COX)、肺炎衣原体(CP)、腺病毒(ADV)、呼吸道合胞病毒(RSV)、甲型流感病毒(IFA)、乙型流感病毒(IFB)和副流感病毒(PIV)(1、2和3型)这9项病原体的IgM抗体,从年龄、季节和性别等方面分析其检出情况。结果:1 713例患者中总阳性率为19.61%(336/1 713);其中COX和IFA未检出;单一病原体阳性率15.29%(262/1713);混合病原体阳性率4.32%(74/1 713),主要是两种病原体的混合感染,以MP合并其他病原体感染为主。9项病原体的阳性率以MP最高,其次是PIV(1、2和3型),再次是IFB,其阳性率分别为16.64%、3.44%和2.16%。从季节来看,春、夏、秋、冬季9项病原体检出率分别为17.15%、21.05%、22.31%和18.85%,各季节之间检出率无差异。从年龄来看,0~12岁组的检出率高于13~59岁组,而13~59岁组的检出率高于60~岁组,三组的检出率依次为38.49%、15.07%和8.86%。从性别来看,男性检出率为16.25%,女性为24.30%,女性高于男性(P<0.001)。结论:MP是上海宝山区不同季节和人群呼吸道感染者中检出率最高的病原体,呼吸道病原体的感染与年龄和性别相关,提示针对性的防范具有临床意义。9项呼吸道病原体联合检测快速、简便、检测范围广,有利于非典型病原体的早期诊断和治疗。

Objective:To analyze the prevalence of IgM antibodies of 9 respiratory pathogens in Baoshan district, Shanghai. Methods: A total of 1 713 serum samples ofrespiratory infection patients in 2017 were collected. The IgM antibodies of 9 pathogens (legionella pneumophila serotype 1, mycoplasma pneumoniae, coxiella burnetii, chlamydia pneumoniae, adenovirus, respiratory syncytial virus, influenza A virus, influenza B virus and parainfluenza virus type 1, 2 and 3) were analyzed by indirect immunofluorescence assay. The prevalence of 9 respiratory pathogens was analyzed by age, season and gender.Results: 19.61% (336/1 713) patients were positive for at least one of 9 respiratory pathogens. No patients were positive for Coxiella burnetii or influenza A virus. Among these 336 positive patients, 262(15.29%) cases were positive for single pathogen infection, while 74(4.32%) cases were infected by mixed pathogens, which mainly due to mycoplasma pneumoniae combined with other pathogens. Mycoplasma pneumoniae, parainfluenza virus(type 1, 2, 3) and influenza B virus were top three positive pathogens, with positive rates of 16.64%, 3.44% and 2.16% respectively. The positive rates of 9 pathogens in spring, summer, autumn and winter were 17.15%, 21.05%, 22.31% and 18.85% respectively, indicating no significant difference of positive rate among seasons. The positive rate was 38.49%, 15.07% and 8.86% in 0-12 years, 13-59 years and over 60 years patients, indicating that 0-12 years patients were the most susceptible population. The positive rate of females(24.30%) was statistically higher than that of males(16.25%).Conclusion: Mycoplasma pneumoniae was the most prevalent pathogen in Baoshan respiratory infections patients. The infection of respiratory pathogens is related to age and sex, indicating the clinical benefit of targeted prevention. The combined detection of 9 respiratory pathogens was a rapid and simple screening method with wide spectrum, which was conducive to the early diagnosis and treatment of atypical pathogens infection.

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