冬季肺炎和哮喘急性加重患儿呼吸道微生物多样性

目的 研究冬季肺炎和哮喘患儿呼吸道微生物的多样性。方法 选择2017年11月至2018年1月在我院急诊科治疗的确诊为肺炎和哮喘急性加重的患儿159例，其中肺炎患儿102例，哮喘急性加重患儿57例。选择同时期在本院就诊的无呼吸道疾病患儿88例，设为对照组。检测患儿呼吸道微生物分布情况。结果 肺炎和哮喘患儿呼吸道微生物多样性增加。肺炎患儿菌群丰度前3位的菌属分别是链球菌属、不动杆菌属、克雷伯菌属。哮喘患儿菌群丰度前3位的分别是嗜血杆菌属、莫拉氏菌属、葡萄球菌属。呼吸道病毒检测结果显示，肺炎患儿检出率前3位的病毒分别是肺炎支原体、呼吸道合胞病毒和副流感病毒3型。哮喘患儿病毒检出率前3位的是柯萨奇病毒、呼吸道合胞病毒和肺炎支原体。肺炎患儿肺炎支原体检出率明显高于哮喘患儿，柯萨奇病毒检出率明显低于哮喘患儿。结论 冬季肺炎和哮喘患儿的临床表现和体征较为相似，但是病原微生物检出情况有所不同。病原微生物检出的差异性有助于正确诊断和鉴别儿童肺炎和哮喘。

Diversity of respiratory microflora in children with acute exacerbation of pneumonia and asthma in winter

Abstract: Objective To explore the diversity of pathogenic microorganisms in children with pneumonia and asthma in winter. Methods 159 children with acute pneumonia and asthma exacerbations who were diagnosed in our hospital from November 2017 to January 2018 were enrolled, including 102 cases of pneumonia and 57 cases of acute exacerbation of asthma. 88 cases of non-respiratory diseases during the same time period were selected as the control group. The distribution of respiratory microbes in children was examined. Results The respiratory microbial diversity in children with pneumonia and asthma increased. The top 3 microbe in pneumonia group were Streptococcus, Acinetobacter and Klebsiella. The top 3 bacteria in acute exacerbation of asthma group were Haemophilus, Moraxella and Staphylococcus. The top 3 respirovirus in pneumonia group were Mycoplasma pneumoniae, respiratory syncytial virus and parainfluenza virus type 3, while the top 3 respirovirus in asthma group were Coxsackie virus, respiratory syncytial virus and Mycoplasma pneumoniae. The detection rate of Mycoplasma pneumoniae in children with pneumonia was significantly higher than that in children with asthma. The detection rate of Coxsackie virus was significantly lower in pneumonia group than that in asthma group. Conclusion The clinical manifestations and signs of children with pneumonia and asthma are similar, but the detection rates of pathogenic microorganisms are different witch can help to correctly diagnose and identify childhood pneumonia and asthma.