肺炎衣原体急性呼吸道感染的临床研究

Clinical study on acute respiratory infection caused by chlamydia pneumoniae

目的了解成人呼吸道感染患者急性肺炎衣原体感染的患病情况及临床特征。方法呼吸道感染住院患者１１０例，同时采集痰和咽拭子标本，应用聚合酶链反应（ＰＣＲ）检测肺炎衣原体ＤＮＡ，及采取静脉血检测肺炎衣原体ＩｇＧ和ＩｇＭ抗体。结果本组患者肺炎衣原体ＩｇＧ抗体的阳性率为７０％（７７／１１０），其中１７例（１６％）有肺炎衣原体近期感染的急性抗体，１２例（１１％）痰和（或）咽拭子肺炎衣原体ＰＣＲ检测结果阳性，联合应用两种方法的阳性率为２３％（２５／１１０）。肺炎衣原体急性感染以支气管哮喘急性发作、肺炎、慢性阻塞性肺疾病急性加重和急性支气管炎患者多见（分别为５７％、３５％、２６％和２５％），其临床表现无特征性。结论结果提示成人呼吸道感染患者肺炎衣原体急性感染的阳性率较高，提示肺炎衣原体是呼吸道感染的重要致病原。

Objective To find out the infected rate and the clinical features of patients with acute respiratory infection caused by chlamydia pneumonia(C. pneumoniae) . Method A prospective study for chlamydia pneumoniae infection was conducted in 110 patients with respiratory tract infection from January to December 1995 in Nanjing. Sputum and throat swab specimens were taken and C. pneumoniae DNA were detected by polymerase chain reaction (PCR) with the HM 1 HR 1 primer pair. At the same time, serum samples were taken and immunoglobulins G and M (IgG and IgM) fractions of antibodies to C. pneumoniae were studied by microimmunofluorescence test. Result Prevalence of specific IgG was 70% in patients with respiratory tract infection. Seventeen patients (16%) were serologically diagnosed as having recent C. pneumoniae infection and 12 patients (11%) had the positive PCR in sputum and/or swab specimens. The total positive rate was 23% (25/110) combining PCR with serology. Acute infection of C. pneumoniae was common in the patients with asthma (57%), pneumonia (35%), COPD (26%) and bronchitis (25%). The clinical feature between C. pneumonia infection ( n =5) and non C. pneumonia infecttion ( n =85) was not significanty different. Conclusion Data suggest that Chlamydia pneumonia is an important pathogen that causes infections of the human respiratory tract and attention should be drawn to this special illness.