肺炎支原体肺炎住院患儿合并病毒感染分析

Analysis of Combined Viral Infections in Hospitalized Children with Mycoplasma pneumoniae

摘要: 目的：分析肺炎支原体肺炎(MPP)住院患儿合并病毒感染的流行病学特征与临床表现，并探索合并病毒感染的影响因素。方法：纳入2023年3月至2024年2月浙江省东阳市人民医院儿科临床诊断为MPP并进行病原学检测的住院患儿，分析流行病学特征及临床表现并采用单因素回归和逐步回归方法探讨合并病毒感染的影响因素。结果：MPP最常见的合并病毒为人鼻病毒和人偏肺病毒，女性患儿病毒感染类型与男性不同，12个月至6岁患儿中人鼻病毒检出率较高，其他年龄段以人偏肺病毒为主，冬季和春季为感染高峰期。合并病毒感染患儿表现出更高的湿罗音发生率(P < 0.001)、更高的炎症标志物(P < 0.05)及更高的丙氨酸氨基转移酶和谷氨酰基转移酶水平(P < 0.05)。回归分析显示，家庭呼吸道症状(OR = 1.58)、冬季(OR = 1.40)、春季(OR = 1.81)与年龄(OR = 0.99)有统计学意义。结论：MPP合并病毒感染患儿存在具有明显的性别、年龄、季节差异，可能出现更严重的炎症反应并影响肝功能，家庭呼吸道症状、冬季、春季可能是合并病毒感染的危险因素，年龄是保护因素。

Abstract: Objective: To analyze the epidemiological and clinical characteristics of hospitalized children with Mycoplasma pneumoniae (MPP) with co-infections, and to explore the influencing factors of co-infections. Methods: Children who were clinically diagnosed with MPP and underwent pathogenetic testing in the Department of Pediatrics of the People’s Hospital of Dongyang City, Zhejiang Province, from March 2023 to February 2024 were enrolled to analyze the epidemiological characteristics and clinical manifestations, and to explore the influencing factors of combined viral infections with one-way regression and stepwise regression methods. Results: The most common co-infections in MPP were human rhinovirus and human metapneumovirus. The co-infections in female children were different from those in male children, and the detection rate of human rhinovirus was higher in children between 12 months and 6 years old, while human metapneumovirus was predominant in the other age groups, with the peak season of infection being winter and spring. Children with co-infections demonstrated a higher incidence of wet rhonchi (P < 0.001), higher inflammatory markers (P < 0.05) and higher alanine aminotransferase and glutamyltransferase levels (P < 0.05). Home respiratory symptoms (OR = 1.58), winter (OR = 1.40), and spring (OR = 1.81) were statistically significant with age (OR = 0.99). Conclusion: The presence of children with MPP combined with viral infections has significant gender, age, and seasonal differences, at the same time there may be a more severe inflammatory response and affect liver function, home respiratory symptoms, winter, and spring may be risk factors for combined viral infections, and age is a protective factor.