小儿病毒性肺炎病毒病原学及免疫功能分析

Etiology and immunological studies on children viral pneumonia.

目的探讨小儿病毒性肺炎的病原学及免疫功能变化。方法采集肺炎组及正常对照组外周血,用ELISA法检测RSVI、FV、ADV、PIV、CMV血清特异性IgM,速率散射比浊法检测IgGI、gAI、gM、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74例病毒性婴幼儿肺炎中,单独病毒感染55例,占大部分,其中RSV 16例居首位,余依次为IFV 12例、ADV 11例、PIV 9例、CMV 7例;混和病毒感染19例,分别是IFV+PIV 7例I、FV+RSV 4例、ADV+PIV4例、ADV+IFV3例、PIV+RSV1例。病毒性肺炎组CD3↓、CD4↓、CD4/CD8↓、CD8↑,与对照组比较差异有统计学意义(P<0.05),而IgGI、gAI、gM与对照组差异无统计学意义(P>0.05)。结论病毒感染是小儿肺炎的主要病原,单独病毒感染为主,病毒病原谱具有地区差异性。病毒性肺炎患儿存在细胞免疫紊乱。

Objective To explore the etiology and immunological changes of children viral pneumonia. Methods Viral specific serum IgM antibodies of five kinds of virus（RSV,IFV,ADV,PIV,CMV）were detected by ELISA. IgG,IgA,IgM and CRP were detected by rate scattered nephelometry. T lymphocyte subpopulations were detected by streptavidin-alkaline phosphatase（S-A/AP）method. Resulits Among 74 viral pneumonia there were 55 cases of single virus infection, successively they were RSV： 16 cases, IFV 12 cases, ADV 11 cases, Pig 9 cases, CMV 7 cases ; there were 19 cases of mixed viral infection, successively they were IFV ＋ PIV 7 cases, IFT ＋ RSV 4 cases, ADV ＋ Pig 4 cases, ADV ＋ IFV 3 eases, Pig ＋ RSV 1 cases. There were significant differences in CD3, CD4, CD4/CD8 counts （ P〈0.05）, there were not significant differences in immunoglbulin IgG, IgA, IgM（ P 〉 0.05） between viral group and controlled group. Conclusion Viral infection was the main etiology,tbe majority was the single viral infection. The viral etiology was not eaual to other area totally, expressing the area discrepancy. The immune function of viral pheumonia infant dedine, concretely expressint T lymphocyte subpopulation was disordery, CD3 , CD4 , CD4/CD8 all decline, CDs rise up, while there was not significant chang in humoral immunity.