CAJ | 학술논문

总结和分析温州地区儿童重症肺炎的病原学特征。方法对2008-2009年在我院诊断为重症肺炎患儿的临床及病原学资料进行回顾性分析。结果共有110例患儿符合诊断，男女比为2.93:1，年龄范围1月龄～15岁，其中＜2岁的婴幼儿占80.91％ (89/110)。76例患儿病原学检测阳性(69.09％)；共检出病原体109株，其中细菌50株(45.87％)，病毒42株(38.53％)，支原体13株(11.93％)。50株细菌中革兰阴性菌38株(76.00％)，革兰阳性菌12株(24.00％)；主要为肺炎克雷伯菌、肺炎链球菌、铜绿假单胞菌、大肠埃希菌及洋葱伯克霍尔德菌。42株病毒中，呼吸道合胞病毒(RSV)26株(61.90％)居首位，其他为流感病毒A型、腺病毒及副流感病毒Ⅰ型和Ⅲ型。在RSV感染患儿中，小于6月龄的有24例，约占该年龄组的38.71％ (24/62)。支原体感染患儿13例，其中2～5岁年龄组9例，占支原体感染患儿总数的69.23％。儿童重症肺炎各季度病原分布构成比之间差异无统计学意义(x2= 15.31，P＞0.05)。结论温州地区儿童重症肺炎好发于小于2岁的婴幼儿；革兰阴性菌是主要的致病菌；RSV是引起小于6月龄婴儿重症肺炎的主要病原体；支原体感染引起的重症肺炎好发于2～5岁幼儿。
총결화분석온주지구인동중증폐염적병원학특정。방법대2008-2009년재아원진단위중증폐염환인적림상급병원학자료진행회고성분석。결과공유110례환인부합진단，남녀비위2.93:1，년령범위1월령～15세，기중＜2세적영유인점80.91％ (89/110)。76례환인병원학검측양성(69.09％)；공검출병원체109주，기중세균50주(45.87％)，병독42주(38.53％)，지원체13주(11.93％)。50주세균중혁란음성균38주(76.00％)，혁란양성균12주(24.00％)；주요위폐염극뢰백균、폐염련구균、동록가단포균、대장애희균급양총백극곽이덕균。42주병독중，호흡도합포병독(RSV)26주(61.90％)거수위，기타위류감병독A형、선병독급부류감병독Ⅰ형화Ⅲ형。재RSV감염환인중，소우6월령적유24례，약점해년령조적38.71％ (24/62)。지원체감염환인13례，기중2～5세년령조9례，점지원체감염환인총수적69.23％。인동중증폐염각계도병원분포구성비지간차이무통계학의의(x2= 15.31，P＞0.05)。결론온주지구인동중증폐염호발우소우2세적영유인；혁란음성균시주요적치병균；RSV시인기소우6월령영인중증폐염적주요병원체；지원체감염인기적중증폐염호발우2～5세유인。
Objective To investigate and analys the etiology of severe pneumonia in children in Wenzhou.Methods A retrospective analysis was performed in pediatric inpatients with severe pneumonia in our hospital from 2008to 2009. All the clinical and etiologic records were collected and analyzed. Results 110 patients were diagnosed as severe pneumonia,and the male-female ratio is 2.93:1. The age of patients ranged from 1 month to 15 years, in which patients younger than 2 years old accounted for 80.91％(89/110). There were 76 patients whose pathogens were identified and 109 strains pathogens were found, in which bacterial pathogens were 50 strains of bacteria(45.87％), 42 strains of virus(38.53％), 13 strains of mycoplasma(11.93％). In 50 strains of bacteria, 38 attains (76.00％) were gram-negative, 12 strains (24.00％) were gram-positive. The predominant bacterial were Klebsiella pneumoniae, Streptococcus pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Burkholderia cepacia. 42 strains of virus were detected, in which 26 strains (61.90％) were respiratory syncytial viruses(RSV), others were influenza virus A, adenovirus, parainfluenza virus Ⅰ and Ⅲ. 24 patients younger than 6 months old suffered from severe pneumonia with RSV infection, which accounted for 38.71％ (24/62) in this age group of severe pneurnonia cases. 13 patients were infected with mycoplasma,in which 9 cases (69.23％) aged from 2 to 5 years old. There was no significant differences amony the rates of cases infected by different pathogeny in different seasons ( x2 = 15.31, P ＞ 0. 05). Conclusions Severe pneumonia in children predominantly occur in patient younger than 2 years old in Wenzhou. Gram-negative bacteria is a crucial pathogen of severe pneumonia in children. RSV is a major pathogens of severe pneumonia in infant younger than 6 months old. Severe pneumonia caused by mycoplasrna predominantly occurs in children aged 2-5 years old.