我院2011—2013年咽拭子肺炎支原体DNA阳性309例分析

目的了解我院近三年肺炎支原体（Mycoplasma pneumoniae,MP）感染的季节分布和临床特点,为早期经验诊治提供有价值的参考。方法对2011年1月至2013年6月在本院门诊和住院治疗、怀疑MP感染的患者,常规采集咽拭子,采用荧光定量PCR技术检测MP-DNA,并对阳性患者进行临床特点分析。结果在研究年限内共送检标本3 745份,MP-DNA阳性309例,阳性率为8.25%;2012年MP-DNA的阳性率为10.47%,显著高于2011年（3.57%）,差别具有统计学意义（χ2=43.67,P〈0.001）;夏秋季节的阳性检出率（10.1%）显著高于冬春季节（4.8%）,差别具有统计学意义（χ2=25.94,P〈0.001）;发病多集中在学龄前儿童和学龄儿童,共占54.7%;86.4%的患者为下呼吸道感染,83.0%的患者血清唾液酸升高;72.0%的儿童患者经阿奇霉素或红霉素治愈。结论夏秋季是本地区MP感染流行的高发季节,学龄前和学龄儿童是感染好发人群,而阿奇霉素仍是治疗儿童MP感染的有效药物。

The clinical features of 309 cases with positive MP-DNA results

Objective To understand the clinical characteristics and seasonal distribution of infection caused by Mycoplasma pneumonia （MP） in the past three years and to acquire scientific knowledge for diagnosing and treating the disease. Method Throat swabs from the outpatients and inpatients who might be infected by MP were obtained from January 2011 to June 2013. MP DNAs were detected by using, fluorescence quantitative polymerase chain reaction. Clinical materials were collected from the MP-DNA positive cases. Findings A total of 3745 samples were detected for MP-DNA and 309 （ 8.25% ） were tested as positive. Higher MP-DNA positive rates in 2012 （ 10.1% ） was found when compared with that in 2011 （3.57%） and the difference was significant（x2 =43.67 ,P 〈0. 001 ）. The MP-DNA positive rate during summer and autumn was 10.1% which was significantly higher than that in winter and spring（4.8% ,X2 = 25.94 ,P 〈 0. 001 ）. In the study, 54. 7% of the MP-DNA positive patients were preschoolers or schoolchildren and 86.4% suffered from lower respiratory tract infections. High serum sialic acid levels were found in 83.0% of the patients and the 72.0% of children were cured with azithromycin or erythromycin. Conclusion MP associated diseases usually occur in summers and autumns. Preschoolers and schoolchildren are susceptible to the disease. Azithromycin is still an effective drug for treating diseases caused by MP in children.