急性呼吸道感染老年患者病毒抗体检测

The Detection on Antibodies in the Aged Patients with the Acute Respiratory Infection.

目的：了解老年急性呼吸道感染(ARI)患者中7种常见病毒感染血清学和临床特点。方法：呼吸内科住院267例ARI患者,收集临床资料,双份血清检测7种侵犯呼吸道的常见病毒IgM抗体,综合分析其特点。结果：267例中病毒抗体检测阳性者129例(48.3%)。其中单纯疱疹Ⅰ型病毒(HSVI)57例(21.3%)；呼吸道合胞病毒(RSV)45例(16.9%)；EB病毒36例(13.5%)；巨细胞病毒(CMV)27例(10.1%)；柯萨奇病毒(COX)18例(6.7%)；风疹病毒(RV)9例(3.4%)；腺病毒(ADV)6例(2.2%)。单一病毒抗体阳性87例(32.6%)；2种病毒抗体混合阳性24例(9.0%)；3种及3种以上病毒抗体混合阳性18例(6.7%)。抗体阳性检出率无性别差异。HSVⅠ感染夏季多发,EB感染冬季多发。混合感染者胸部X线表现以结节状影和磨玻璃状影较多,单一抗体阳性患者胸部X线片无异常39例(44.8%)；肺纹理紊乱32例(36.8%)；网状影25例(28.7%)。高热(T≥38.5℃)92例；干咳42例；卡他表现38例；咯血18例；胸痛16例。伴高血压病45例、糖尿病19例、冠心病18例。结论：病毒是引起老年人急性呼吸道感染的常见病原体,以HSVⅠ,RSV,EB和CMV较为多见。冬春季是多发季节。主要表现高热、干咳、咯血、胸痛,头痛。胸部X线表现混合感染者以结节状影或磨玻璃状影较多,而单一病毒感染者肺纹理增多紊乱和网状影较常见,也可无明显异常。多种病毒感染常见于伴有基础疾病者。

Objective：To explore the serologic and clinical characteristic of aged cases with acute respiratory infection （ARI） who infected by 7 kinds of common virus. Methods： A total of 267 inpatients with ARI in resent 4 years were observed. Seven types of specific respiratory viral IgM antibodies were tested by ELISA and clinical data was analyzed . Results： Among 267 ARI patinets ,The positive results of 7 types of viral IgM antibodies test were found in 129（48.3%） The detected positive rates were 57 cases （21.3%） for HSVⅠ, 45cases （16. 9%） for RSV, 36 cases （13. 5%） for EB, 27 cases （10. 1%） for CMV, 18 cases （6. 7%） for COX, 9 cases （3.4%） for RV and 6 cases （2. 2%） for ADV. 87 cases （32. 6%） had positive result for one kind of virus, 24 cases （9. 0%） had two positive results and 18cases （6.7%） had more than two positive results. There was no statistically significant difference between male and female. It was more frequently for HSVⅠ infection to be founded in summer and EB infection in winter. Chest X-ray result showed that nodules and ground glass abnormality in complex infection; normal 39 cases held 44.83% ; disturbance of lung markings 32 cases held 36.78% and reticular opacity 25 cases held 28.74% in single virus infection. Among all the patients, 92 cases had hyperpyrexia （T≥38.5℃） ; 42 cases had unproductive cough; 38 cases had catarrh; 18 cases had hemoptysis; 16 cases had chest pain. There were 54 cases had basic disease, 47 cases of them suffering from hypertension, 23 cases suffering from Diabetes mellitus and 24 cases suffering from coronary heart disease. Conclusion..Virus was the most common pathogen, which caused acute respiratory infection in aged person. Among them HSVⅠ, RSV, EB and CMV infection were very common. In winter and spring, aged person were more likely suffered from ARVⅠ. Hyperpyrexia, unproductive cough, hemoptysis, chest pain and headache could be found easily in the patients＇ manifestation From the patients＇ chest X-ray result we can make a conclusion that nodules or ground glass abnormality was more common in complex infection and normal; disturbance of lung markings or reticular opacity were more common in single virus infection. The result of viral lgM antibody test might be mixed infection in patients with basic disease.