| 李长春,朱玉林,王亚亭,等.509例儿童社区获得性肺炎病原体及临床特征分析[J].安徽医药,2016,20(4):699-702. |
| 509例儿童社区获得性肺炎病原体及临床特征分析 |
| Analysis of pathogens and clinical characteristics of 509 children with community acquired pneumonia |
| 投稿时间：2016-01-15 |
| DOI： |
| 中文关键词: 社区获得性肺炎 病原体 临床特征 儿童 |
| 英文关键词: community-acquired pneumonia pathogen clinical characteristics child |
| 基金项目:安徽省自然科学基金(No 1408085QH157) |
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| 中文摘要: |
| 目的 了解儿童社区获得性肺炎(community-acquired pneumonia,CAP)病原分布状况及其临床特征。方法 回顾性分析509例CAP住院患儿的病例资料,分析各种病原的检测结果及不同病原CAP的临床特点。结果 509例CAP患儿中,299例病原学检测阳性,阳性率58.74%。其中,肺炎支原体128例(25.15%)、乙型流感病毒90例(17.68%)、副流感病毒49例(9.63%)、呼吸道合包病毒18例(3.54%)、腺病毒18例(3.54%)、甲型流感病毒2例(0.39%)。352例患儿细菌学检查中,43例细菌培养结果阳性,其中流感嗜血杆菌22例(6.25%),肺炎链球菌17例(4.83%),金黄色葡萄球菌2例(0.57%),肺炎克雷伯杆菌1例(0.28%),大肠埃希菌1例(0.28%)；2种以上病原混合感染50例(9.82%)。肺炎支原体、病毒在≤3岁和＞3岁组的检出率有差异(P<0.05)。肺炎支原体肺炎患儿在患病年龄、发热、喘息症状、中性粒比值、C反应蛋白(CRP)上与乙型流感病毒肺炎有差异(P＜0.05)。＞5岁与≤5岁的肺炎支原体肺炎患儿的喘息比例、入院体温、白细胞数、中性粒比及CRP值有差异(P＜0.05)。结论 该地区儿童CAP 常见的病原有肺炎支原体、乙型流感病毒、流感嗜血杆菌等。病毒是3 岁以下儿童CAP 的主要病原,以乙型流感病毒常见；肺炎支原体感染多见于3岁以上患儿,5岁以上患儿炎症反应更重。不同病原CAP临床特点不同,肺炎支原体肺炎患儿的患病年龄、发热症状比例、中性粒比值、CRP值高于乙型流感毒性肺炎患儿；喘息症状比例较后者低。 |
| 英文摘要: |
| Objective To understand the pathogens distribution and clinical characteristics of community-acquired pneumonia (CAP) in children.Methods The data of 509 cases of hospitalized children with CAP were retrospectively analysed. Detection results of various pathogens and clinical characteristics of CAP with different pathogens were also analysed.Results Overall,299 cases had been detected with at least one pathogen,and the positive rate was 58.74%.Among them,128 cases were MP positive (25.15%),90 cases influenza Bvirus positive (17.68%),49 cases parainfluenza virus positive (9.63%),18 cases respiratory syncytial virus positive (3.54%),18 cases adenovirus positive (3.54%),2 cases influenza Avirus positive (0.39%),22 cases haemophilus influenzae positive (6.25%),17 cases streptococcus pneumoniae positive (4.83%),2 cases staphylococcus aureus positive (0.57%),1 case Klebsiella pneumoniae positive (0.28%),and 1 case Escherichiacoli positive (0.28%).Two or more pathogens infections were present in 50 out of 509 cases (9.63%).The detection rates of mycoplasma pneumoniae or virus have significant differences between the less than 3 years old group and the more than 3 years old group (P<0.05),The age,ratio of fever and breathing,neutrophil percentage and Creactive protein of the cases with mycoplasma pneumoniae pneumonia have differences as compared to the cases infected by influenza Bvirus.The ratio of breathing,admission body temperature,white blood cell count,neutrophil percentage and Creactive protein of the cases with mycoplasma pneumoniae pneumonia have differences between the less than 5 years old group and the more than 5 years old group.Conclusions Mycoplasma pneumoniae pneumonia,influenza Bvirus and haemophilus influenzae were common pathogens of CAP in children in this region.Virus was the main pathogen of CAP children under 3 years old,especially the influenza Bvirus.Mycoplasma pneumoniae was more prevalent in more than 3 years old children.Children more than 5 years old with mycoplasma pneumoniae pneumonia have a heavier inflammatory reaction.Community-acquired pneumonia in children has different clinical characteristics with different pathogens.The ratio of fever, neutrophil percentage and Creactive protein of the cases with mycoplasma pneumoniae pneumonia were higher than CAP children infected by influenza Bvirus,while the ratio of breathing was lower than CAP infected by influenza Bvirus. |
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