婴幼儿病毒性肺炎病原学及免疫功能研究

Etiology and Immunological Studies on Infant Viral Pneumonia

目的:探讨婴幼儿病毒性肺炎的病原学及免疫功能变化。方法:采集婴幼儿肺炎组及正常对照组外周血,用ELISA法检测RSV、IFV、ADV、PIV、CMV血清特异性IgM,速率散射比浊法检测IgG、IgA、IgM、CRP,碱性磷酸酶标记链霉卵白素(S-A/AP)法检测T淋巴细胞亚群。结果:104例婴幼儿病毒性肺炎中,单独病毒感染75例,占大部分,其中RSV21例居首位,余依次为IFV18例、ADV15例、PIV11例、CMV10例;混和病毒感染29例,分别是IFV+PIV10例、IFV+RSV6例、ADV+PIV6例、ADV+IFV5例、PIV+RSV2例。病毒性肺炎组CD3↓、CD4↓、CD4/CD8↓、CD8↑,与对照组比较有显著差异(P<0.05),而IgG、IgA、IgM与对照组无显著差异(P>0.05)。结论:病毒感染是婴幼儿肺炎的主要病原,单独病毒感染为主,混和感染为辅,病毒病原谱具有地区性差异。病毒性肺炎患儿存在细胞免疫紊乱。

Objective： To explore the etiology and immunological changes of infant viral pneumonia in Luzhou area. Methods： Viral specific serum lgM antibodies of five kinds of virus （ RSV, IFV. ADV, PIV CMV） were detected by ELISA lgG, lgA, lgM and CRP were detected by rate scattered nephelometry. T lymphocyte subpopulations were detected by streptavidin -alkaline phosphates （S- A/AP） method. Results： Among 104. viral pneumonia there were75cases of single virus infection, successively they were RSV： 21cases （20. 1% ）, IFV： 18 cases （ 17. 3% ）, ADV： 15 cases （ 14. 4% ）, PIV： 1 lcases （ 10. 6% ）, CMV： 10cases （ 17. 3% ） ; there were 29 cases of mixed viral infection, successively they were IFV ＋ PIV： 10 cases （9. 6% ）, IFV ＋ RSV 6 caces （5. 8% ）, ADV ＋ PIV： 6 cases （5.8%）, ADV ＋ IFV 5 cases （4. 8% ）, PIV ＋ RSV： 2 cases （ 1.9% ） . There were significant differences in CD3. CD4, CD4/CD8 counts （all P 〈 0. 05 ）, there were not significant differences in immunoglobulin lgG, lgA, lgM （ all 〉 0. 05 ） between viral group and controlled group. Conclusion： Viral infection was the main etiology, the majority was the single viral infection. The viral etiology was not equal to other area totally , expressing the area discrepancy The immune function of viral pneumonia infant dedine, concretely expressing T lymphocyte subpopulation was disordery, CD3, CD4, CD4/CD8 all decline , CD8 rise up , while there was not significant change in humeral immunity.