摘要
目的分析2023年我院呼吸道感染的流行病学特征及血清学指标变化,为呼吸道感染疾病的诊断和治疗提供依据。方法选取2023年1月至2023年12月就诊于北京佑安医院的483例呼吸道病原体IgM阳性者为研究对象,采用间接免疫荧光法检测血清中的肺炎支原体(MP)、肺炎衣原体(CP)、甲型流感病毒(INFA)、副流感病毒(PIV)、呼吸道合胞病毒(RSV)、腺病毒(ADV)、柯萨奇病毒(COX)、嗜肺军团菌(LP)、乙型流感病毒(INFB)9种病原体免疫球蛋白(Ig)M抗体。采用卡方检验对不同性别、年龄、季节患者的血清呼吸道病原体IgM阳性率进行统计分析,采用Kru’skal-Wallis检验分析不同病原体感染者间的血清学指标。结果(1)483例呼吸道感染患者中,单一病原体IgM阳性者占比为39.3%(190/483),>2种病原体IgM阳性者占比为60.7%(293/483)。单一病原体IgM阳性患者中,位居前3位的依次为INFB(39.5%,75/190)、INFA(24.2%,46/190)及MP(20%,38/190);混合病原体IgM阳性患者中,以2种病原体混合感染为主,占比为61.7%(181/293),其中以病原体INFA+INFB为主,占比43.3%(127/293),其次为MP+INFA+INFB,占比17.4%(51/293)。(2)女性患者血清MP、ADV IgM阳性率高于男性,INFB IgM阳性率低于男性,差异均具有统计学意义(P<0.05)。(3)0~18、19~45、46~59、>60岁4个年龄段患者血清MP、COX病原体IgM阳性率比较,差异均有统计学意义(P均<0.05),其中0~18岁MP、COX阳性率分别高于19~45、46~59、>60岁(P均<0.05),19~45岁MP阳性率高于46~59、>60岁(P均<0.05)。(4)春、夏、秋、冬4个季节血清MP、INFA IgM阳性率比较,差异有统计学意义(P<0.05);其中春季MP阳性率高于秋季(P<0.05),冬季阳性率分明高于夏季、秋季(P均<0.05);INFA阳性率冬季高于夏季(P<0.05)。(5)将483例呼吸道感染者分为MP IgM阳性组、病毒IgM阳性组、混合感染组,3组间eGFR、EOS、PLT比较,差异有统计学意义(P<0.05),其中混合感染组中EOS高于MP IgM阳性组(P<0.05),eGFR、PLT高于病毒IgM阳性组(P均<0.05),肝功能指标在3组间比较差异无统计学意义(P>0.05)。结论2023年全年以MP、INFA、INFB病原体感染为主,且混合感染多见;女性及年龄小的人群更易感染MP;春季和冬季更易发生MP感染,甲型流感病毒更易发生于冬季;混合感染可能更易引起机体的免疫反应。
Objective To analyze the epidemiological characteristics and the trend of serological indicator changes of respiratory infections in our hospital in 2023 and to provide a knowledge basis for the diagnosis and treatment of respiratory infectious diseases.Methods A cohort of 483 patients with respiratory tract infections admitted to Beijing You’an Hospital between January,2023 and December,2023,were selected for the study.Indirect immunofluorescence assay was conducted to detect immunoglobulin M(IgM)antibodies to nine respiratory pathogens in serum samples,including Mycoplasma pneumoniae(MP),Chlamydophila pneumoniae(CP),influenza A virus(INFA),parainfluenza virus(PIV),respiratory syncytial virus(RSV),adenovirus(ADV),Coxsackie virus(COX),Legionella pneumophila(LP),and influenza B virus(INFB).Chi-square test was applied to statistically analyze the positive rates of serum respiratory pathogens IgM antibodies in patients of different groups of gender,age,and season,and Kruskal-Wallis test was used to analyze the serological indicators among patients infected with different types of pathogens.Results(1)Among 483 cases of respiratory tract infections,the proportion of single pathogen IgM-positive individuals was 39.3%(190/483),while the proportion of>2 pathogens IgM-positive individuals accounted for 60.7%(293/483).Among single-pathogen IgM-positive patients,the top three pathogens were INFB(39.5%,75/190),INFA(24.2%,46/190),and MP(20%,38/190)in a descending order.Among patients positive for mixed pathogen IgM,dual-pathogen infections were predominant,accounting for 61.7%(181/293),with INFA+INFB being the most common combination,accounting for 43.3%(127/293),followed by MP+INFA+INFB,accounting for 17.4%(51/293).(2)Female patients exhibited higher serum positivity rates for MP and ADV IgM compared to males,while the positivity rate for INFB IgM was lower than that of males,with all differences being statistically significant(P<0.05).(3)When comparing the serum positivity rates of MP and COX pathogens among patients in four age groups(0-18 years,19-45 years,46-59 years,and>60 years),differences were all statistically significant(P<0.05).Specifically,the positivity rates of MP and COX in the 0-18 years group were higher than those in the 19-45 years,46-59 years,and>60 years groups(all P<0.05).The positivity rate of MP in the 19-45 years group was higher than that in the 46-59 years and>60 years groups(all P<0.05).(4)When comparing serum positivity rates of MP and INFA among four seasons(spring,summer,autumn,and winter),differences were statistically significant(P<0.05).Specifically,the positivity rate of MP was higher in spring than in autumn(P<0.05),and the rate in winter was significantly higher than in summer and autumn(all P<0.05).The positivity rate of INFA in winter was higher than in summer(P<0.05).(5)Among 483 cases of respiratory tract infections,when divided patients into groups based on MP IgM positivity,virus IgM positivity,and mixed infection,comparisons of eGFR,EOS,and PLT showed statistically significant differences(P<0.05).Specifically,in the mixed infection group,EOS was higher than in the MP IgM-positive group(P<0.05),while eGFR and PLT were higher than in the virus IgM-positive group(all P<0.05).There were no significant differences in liver function indicators among the three groups(P>0.05).Conclusion In 2023,MP,INFA,and INFB pathogens were the main infections throughout the year,with mixed infections being the common type.Females and younger individuals were more susceptible to MP infections.MP infections were more likely to occur during spring and winter,while influenza A virus was more likely to occur in winter.These results suggest that mixed infections could be more likely to trigger immune responses.
作者
孙海青
刘辉
娄金丽
刘宁
SUN Haiqing;LIU Hui;LOU Jinli;LIU Ning(Department of Clinical Laboratory,Beijing You’an Hospital,Capital Medical University,Beijing 100069,China;Joint Laboratory of Viral Hepatitis Related Liver Disease Research,Capital Medical University,Beijing 100069,China)
出处
《标记免疫分析与临床》
CAS
2024年第6期1084-1090,共7页
Labeled Immunoassays and Clinical Medicine
基金
首都卫生发展科研专项公共卫生项目(编号:首发2021-1G-4302,首发2021-1G-4301)
首都医科大学基础临床联合实验室开放课题。
关键词
呼吸道感染
呼吸道病原体
IGM抗体
流行病学
Respiratory tract infection
Respiratory pathogens
IgM antibody
Epidemiology
