摘要目的 探讨杭州地区不同年龄段儿童急性上呼吸道感染肺炎支原体、EB病毒和巨细胞病毒检出情况和季节流行特点.方法 采集2011年1月至2012年12月杭州市第一人民医院5942例急性上呼吸道感染患儿的咽拭子和痰液样本,采用荧光定量PCR方法检测肺炎支原体(Mycoplasma pneumoniae,MP)、EB病毒(Epstein-Barr virus)、巨细胞病毒(Cytomegaoviyns,CMV),并采用x2检验对不同年龄段患儿病原体的检出率和季节流行变化进行统计学分析.结果 5942例急性上呼吸道感染患儿中,MP、EB病毒、CMV的检出率分别为29.91％(1777/5942),22.92％(1362/5942),8.55％(508/5942),其中556例(9.36％)患儿同时检出两种或两种以上病原体.各年龄段MP检出率差异有统计学意义(x2=113,P=0.000),其中＞6岁年龄组的MP检出率最高(448/1012,44.36％);EB病毒在0～1岁患儿中检出率最低(7.00％),与其他三个年龄段相比差异具有统计学意义(x2=167,181和187,P=0.000);0～1岁患儿中CMV检出率最高(23.78％).各月份MP检出率差异具有统计学意义(x2=208和211,P=0.000),7、8月份达高峰.结论 杭州地区儿童急性上呼吸道感染非典型病原体以MP为主,MP与EB病毒的混合感染也多见.MP和EB病毒的感染率随年龄的上升而升高,而CMV则以0～1岁的婴儿多见.MP感染率在冬春季节较低,夏秋季节增高.

abstractsObjective To investigate the epidemiological characteristics of mycoplasma pneumoniae (MP),Epstein-Barr virus (EB virus) and cytomegalovirus (CMV) infection in children with acute upper respiratory tract infections in Hangzhou.Methods Throat swabs and sputum samples were collected from 5942 children with acute upper respiratory tract infections in Hangzhou First People's Hospital during January 2011 and December 2012.MP,EB virus and CMV were detected using quantitative PCR.The distribution and seasonal changes of the above pathogens in children of different ages were analyzed using Chi-square tests.Results MP,EB virus and CMV were positive in 29.91％ (1777/5942),22.92％ (1362/5942) and 8.55％ (508/5942) children,respectively.Mixed infections were found in 556 (9.36％) children.The positive rates of MP varied among different age groups (x2 =113,P =0.000),and the highest one was detected in children ＞ 6-year old (448/1012,44.36％).EB virus infection was rare in age group 0-1 year,and the positive rate was of statistical difference from those in other age groups (x2 =167,181 and 187,P =0.000).The highest positive rate of CMV (23.78％) was found in children aged 0-1 year old.The positive rates of MP varied in different months of the year (x2 =208 and 211,P =0.000),and the highest positive rate was found in July and August.Conclusion The predominant pathogen of acute upper respiratory tract infection in children is MP in Hangzhou,and MP plus EB virus infection is common,particularly in older children;while CMV infection more likely occures in 0-1 year old babies,and usually in summer.