流感嗜血杆菌b型与急性呼吸道感染关系的研究

A study on the relationship between Haemophilus influenzae b and acute respiratory infection

目的进一步了解急性呼吸道感染中流感嗜血杆菌（ＨＩ）感染的发病情况。方法采用单克隆抗体夹心酶联免疫吸咐法，对３６例上呼吸道感染、３２例支气管炎、７０例肺炎患儿及４５例健康对照组的血、尿进行ｂ型ＨＩ外膜蛋白（ＨｉｂＯＭＰ）抗原的检测，并对７０例肺炎患儿的血清进行ＨｉｂＯＭＰ抗体检测。结果３６例上呼吸道感染患儿中有４例为ＨｉｂＯＭＰ抗体阳性，３２例支气管肺炎患儿中有４例阳性，７０例肺炎患儿中有１８例为阳性；４５例健康对照组中仅１例为ＨｉｂＯＭＰ抗原阳性。肺炎组抗原检出率高于对照组（χ２＝１０．９６０，Ｐ＜０．０１）。７０例肺炎中１８例ＨｉｂＯＭＰ抗体阳性。抗原、抗体检测共有２４例（包括抗原、抗体均阳性１２例，仅抗原或抗体阳性各６例）肺炎获得阳性结果。结论１１．１％的上呼吸道感染、１２．５％支气管炎和３４．３％的肺炎患儿为Ｈｉｂ感染；抗原、抗体联合检测可使Ｈｉｂ检出率提高。

Objective To study the role of Haemophilus influenzae (HI) in the acute respiratory tract infection. Methods The Mab enzyme linked immunosorbent assay was used to detect Haemophilus influenzae type b outer membrane protein (Hib OMP) antigen in the serum and urine of 70 cases of pneumonia, 32 cases of brochitis, 36 cases of acute upper respiratory tract infection, and 45 healthy controls. Patients with pneumonia were further studied by the assay of Hib OMP antibody. Results Eighteen out of 70 cases of pneumonia, 4 out of 32 cases of bronchitis and 4 out of the 36 cases of acute upper respiratory tract infection were Hib OMP antigen positive. However, only 1 out of 45 healthy controls was Hib OMP antigen positive. The positive rate for Hib antigen in cases of pneumonia was much higher than that of healthy controls (χ 2=10.960, P <0.01). By means of Hib OMP antibody assay, 18/70(25.7%) cases of pneunmonia were found positive. A total of 24 cases of pneumonia including 12 cases had both positive Hib OMP antigen and its antibody, 6 cases positive Hib OMP antigen only and another 6 positive Hib OMP antibody only were revealed to have HI infection. Conclusion 11 1% of cases of upper respiratory tract infection, 12.5% of cases of bronchitis and 34.3% of cases of pneumonia had Hib infection. A combined application of Hib OMP antibody and antigen detection can enhance the detective rate of Hib infection.