新生儿肺炎病原学及临床研究——附169例分析

Etiology and clinical study of pneumonia in newborn-with analysis of 169 cases

目的 :研究新生儿肺炎的病原和临床表现。方法 :采用酶联免疫吸附 (EL ISA)法检测了血清呼吸道病毒抗体 :合胞病毒抗体、腺病毒抗体、柯萨其病毒抗体、巨细胞病毒抗体、鼻咽病毒抗体 ,用颗粒凝集试验检测咽试子肺炎支原体抗体 ,使用金标法检测沙眼衣原体抗原 ,咽试子解脲支原体培养以及痰培养。部分病例同时检测 10种病原体 ,即除上述病毒外 ,尚有流感病毒 ,副流感病毒 ,检测内容包括抗原、抗体。结果 :大部分病例 (简称大组 )只检测病毒抗体 Ig M或 Ig A,检出率只有 6 .2 5 % ,MP- Ig M阳性率 4 .71% ,UU培养阳性率 4 1.6 7% ,CT(抗原 )阳性率 16 .6 7% ,痰培养 4 4 .94 % ;另有 2 5例 (简称小组 )进行了 10种肺炎病原学调查 ,病毒抗原有 2 3例次阳性 ,在 15例患婴中测出 ,病毒抗体阳性 4例次 ,在 2例患婴中测出 ,下呼吸道痰培养阳性率 92 .0 0 %。结论 :新生儿肺炎的病原学研究提示 ,病毒抗体检出率较低 ,有条件应做抗原检测。支原体感染以 UU为主 ,CT感染并不少见 ,应引起足够重视。痰培养仍应作为重要的检查手段。新生儿肺炎临床表现仍以气促、发绀。

Objective:To study the pathogen and clinical manifestation of pneumonia in newborn Methods:Serum viral antibody in respiratory tract including syncytial virus antibody、adenovirus antibody、Coxsackie virus antibody、cytomegalovirus antibody、nasopharyngeal virus antibody were measured by ELISA method Mycoplasma pneumonia antibody was measured by granular agglutinating test with throat swab,chlamydia trachomat antigen by gold standard method UU culture and sputum culture were examined by throat swab Ten pathogens including described above virus and influenza virus,parainfluenza virus were measured in several patients in which antibody and antigen were measured Results:Only virus antibody IgM or IgA were measured in most cases The positive rate was 6 25% Positive rate of MP IgM was 4 71%,UU culture 41 67%,CT(antigen)16 67%,sputum culture 44 94% Ten of pathogen pneumonia were studied in 25 patients Viral antigen was positive in 23 cases in 15 newborns,viral antibody positive in 4 cases in 2 newborns Sputum culture in lower respiratory tract positive rate was 92 00% Conclusion:The etiology study of pneumonia in newborn in this paper suggested low viral antibody positive rate Antigen should be measured if possible Mycoplasma infection was mostly UU infection and CT infection was also not seldom This should be emphasized Sputum culture was still an important examination method The manifestation of pneumonia in newborn was respiratory tract symptoms such as short breath cyanosis cough 〔