摘要
目的探讨上海宝山地区某医院2017-2023年患者呼吸道病原体的流行性情况。方法选取2017年1月-2023年7月本院因呼吸道疾病就诊的门诊和住院患者449890例,检测的病原体包括流感病毒(influenza virus,INF)(包含甲型流感病毒FluA和乙型流感病毒FluB)、肺炎支原体(mycoplasma pneumoniae,MP)、呼吸道合胞病毒(respiratory syncytical virus,RSV)、腺病毒(adenovirus,ADV)、柯萨奇病毒A型(Coxsackievirus A,CVA)、柯萨奇病毒B型(Coxsackievirus B,CVB)、人细小病毒B19(human parvovirus B19,HPV B19)、腮腺炎病毒(mumps virus,MV)、结核杆菌。探讨年份、年龄、季节和性别与呼吸道病毒阳性率的相关性,分析对照组和观察组在阳性率和性别上的统计学差异。为分析新冠疫情对呼吸道感染的影响,以2017年1月-2019年12月检测出病原体的患者为对照组,2020年1月至2023年7月检测出病原体的患者为观察组。同时探索2023年2~4月份甲流阳性率与年龄、性别和就诊科室的关系。结果2019年呼吸道感染率最高(6.06%),2020年疫情刚刚开始,感染率下降一半(3.51%),2021和2022年年感染率逐渐降低,分别为1.81%和1.65%。卡方检验发现除了呼吸道合胞病毒、柯萨奇病毒B型、结核IgM外对照组的感染率均高于观察组,均有统计学差异。不同年龄段的呼吸道感染率不同,小于等于18岁的人群呼吸道感染率较高为6.74%(11772/174728),大于18岁的人群呼吸道感染率较低是2.75%(7565/275162)。男性的呼吸道感染率均高于女性,但是仅有甲流、乙流、呼吸道合胞病毒、柯萨奇病毒B型和结核IgG抗体在男女间的感染率有统计学差异。甲流、乙流和呼吸道合胞病毒在冬季和春季检出为主,腺病毒在冬季(2.1%)检出为主,肺炎支原体在四季的感染率均较高且冬季最高(10.73%),柯萨奇病毒A、B型和人细小病毒B19在春季发病率最高,腮腺炎病毒在冬季最易感染(0.6%),结核IgG和IgM抗体在冬季检出为主。在3月份第二周,甲流的检测数(n=5682)和甲流的阳性例数(n=977)均达到了最高峰,阳性率是3月份第一周最高为22.63%。就诊主要病因为呼吸道感染达到49.61%,就诊科室主要以儿科(43.05%)为主。结论呼吸道感染具有季节性,在冬季感染率最高,预防是降低呼吸道感染的主要措施。
Objective To analyze the epidemiological analysis of respiratory pathogens in patients in Baoshan area,Shanghai from 2017 to 2023.Methods A total of 449890 outpatients and inpatients with respiratory diseases from January 2017 to July 2023 were enrolled,and 11 common respiratory pathogens were detected,including Influenza virus A(FluA),Influenza virus B,FluB,Mycoplasma pneumoniae(MP),respiratory syncytial virus(RSV),adenovirus(ADV),Coxsackievirus A(CVA),Coxsackievirus B(CVB),human parvovirus B19(HPV B19),mumps virus(MV),and Mycobacterium tuberculosis.The correlation of year,age,sex and season with respiratory infection rate was investigated,and the statistical difference in positive rate and sex between the observation group and the control group was analyzed.In order to analyze the impact of the new crown epidemic on respiratory infections,the patients with pathogens detected from January 2017 to December 2019 were taken as the control group,and the patients with pathogens detected from January 2020 to July 2023 were taken as the observation group.The correlation of 2023 influenza A outbreak with age,sex and department of visit was explored.Results The respiratory infection rate was the highest in 2019(6.06%),and the infection rate decreased by half(3.51%)in 2020 when the epidemic just began,and gradually decreased in 2021 and 2022,to 1.81%and 1.65%,respectively.Chi-square test found that except for respiratory syncytial virus,coxsackievirus type B and tuberculosis IgM,the infection rate of the control group was higher than that in the observation group,and there were statistical differences.The respiratory infection rate of people under or equal to 18 years old was higher at 6.74%(11772/174728),and the respiratory infection rate in people over 18 years old was lower at 2.75%(7565/275162).The prevalence of respiratory infections in male was higher than in female,but only influenza A,B,respiratory syncytial virus,coxsackievirus type B,and tuberculosis IgG antibody infection rates were statistically different between male and female.Influenza A,B and respiratory syncytial virus were mainly detected in winter and spring,adenovirus was mainly detected in winter(2.1%),and the infection rate of Mycoplasma pneumoniae was higher in all seasons and the highest in winter(10.73%).Coxsackievirus A,B and human parvovirus B19 were the highest in spring,mumps virus was most susceptible to infection in winter(0.6%),and tuberculosis IgG and IgM antibodies were mainly detected in winter.In the second week of March,both the number of tests for influenza A(n=5682)and the number of positive cases for influenza A(n=977)reached their peak,with the positive rate peaking at 22.63%in the first week of March.The main causes of respiratory tract infection reached 49.61%,and the main departments were pediatrics(43.05%).Conclusion Respiratory tract infection is seasonal,with the highest infection rate in winter,and prevention is the main measure to reduce respiratory infection.
作者
陈龙梅
刘万超
CHEN Longmei;LIU Wangchao(Department of Clinical Laboratory,Baoshan District Traditional Chinese and Western Medicine Hospital,Shanghai 201999,China)
出处
《临床肺科杂志》
2023年第12期1878-1884,共7页
Journal of Clinical Pulmonary Medicine
