急性喉炎患儿非细菌病原学分析

摘要

Objective To explore the non-bacteria pathogens of acute laryngitis in children. Methods The clinical data and sputum sample were collected from 325 patients hospitalized due to acute laryngitis in consecutive 10 years from January 2006 to December 2015 . The multiple non-bacteria pathogens were detected and analyzed with clinical data. Seven types of respiratory viruses were detected by direct immunolfuorescence. Mycoplasma pneumoniae (MP), Chlamydia pneumoniae (CP), and Boca virus (HBoV) were detected by lfuorescence quantitative PCR. The rhinovirus (HRV) and human metapneumovirus (hMPV) were detected by RT-PCR. Venous blood was collected within 24 h after hospitalization and 7-10 d after treatment. The MP antibody of IgG and IgM were detected by ELISA. Results The detection rate of non-bacteria pathogens was 46 . 2%in 325 children with acute laryngitis ( 150/325 ), including 76 cases ( 23 . 4%) of virus and 99 cases ( 30 . 5%) of MP. Virus detection rate in 1-3 year old children was obviously higher than in 0-1 year old children and over 3 years old children (χ2 = 9 . 527 , P= 0 . 009 ). With the increase of age, the detection rate of MP increased gradually (χ2 = 10 . 132 , P= 0 . 006 ). The detection rates of RSV and hBoV were higher in under 3-year-old children. The detection rates of virus in winter and spring were signiifcantly higher than those in summer and autumn (χ2 = 5.064, P= 0.024). The detection rates of MP in winter, spring, summer, and autumn was 13.1%, 25 . 0%, 38 . 2%, and 44 . 9%respectively, and the MP detection rates were increased gradually over seasons (χ2 = 4 . 438 , P= 0 . 035 ). The detection rate of RSV was higher in winter, and hBoV was higher in summer. Conclusion Acute laryngitis mainly occurred in children under 3-years-old children, and the detected non-bacteria pathogens were different among different ages and seasons. Virus was the major pathogens in young children, while MP was more common in older children.%目的：了解儿童急性喉炎的非细菌病原学特点。方法收集2006年1月至2015年12月连续10年间因急性喉炎住院治疗的325例患儿的病史资料及痰标本，进行多病原联合检测并结合病史资料进行分析。直接免疫荧光法检测7种常见呼吸道病毒，荧光定量PCR法检测肺炎支原体（MP）、肺炎衣原体（CP）及博卡病毒（HBoV），RT-PCR法检测鼻病毒（HRV）及偏肺病毒（hMPV），入院24 h内及治疗7~10 d采集静脉血，ELISA法检测血清特异性MP抗体IgG、IgM。结果325例急性喉炎患儿非细菌病原学检出率为46.2%（150/325）。检出病毒76例（23.4%），MP 99例（30.5%）。1~3岁组患儿病毒检出率明显高于<1岁及≥3岁组患儿（χ2=9.527，P=0.009）。随着年龄的增加，MP检出率逐渐升高（χ2=10.132， P=0.006）。0~3岁组RSV及hBoV检出率较高。冬春季病毒检出率明显高于夏秋季（χ2=5.064，P=0.024）。冬、春、夏、秋季MP检出率分别为13.1%、25.0%、38.2%、44.9%，MP检出率逐渐升高（χ2=4.438，P=0.035）。RSV冬季检出率高，hBoV夏季检出率较高。结论急性喉炎主要发生于< 3岁儿童，不同年龄及季节的病原检出不同。病毒是小年龄组的主要病原，大年龄组则以MP较为多见。