肺炎支原体、衣原体IgM抗体在慢性阻塞性肺疾病急性加重期的检出率研究

Detecting mycoplasma and chlamydia pneumonia in acute exacerbation of chronic obstructive pulmonary diseases

[目的]探索肺炎支原体（MP）、衣原体（CP）IgM抗体在免疫功能正常、异常的慢性阻塞性肺疾病急性发作（AECOPD）患者中检出率的差别。[方法]收集2007年12月～2008年3月收治的AECOPD患者60例。所有病例入院时均测定IgA、IgM、IgG、C3、C4等,任何一项低于正常值都归为免疫功能异常组,其他病例为对照组。入选免疫功能异常组20例,平均年龄（76.3±6.6）岁;对照组40例,平均年龄（69.7±10.1）岁。入院当天及1周采外周血2 mL,使用ELISA法检测血清中MP、CP IgM抗体。[结果]免疫功能异常组MP、CP IgM检出率分别为25.0%（5/20）、15.0%（3/20）,对照组分别为15.0%（6/40）、12.5%（5/40）。两组比较差异均无统计学意义,P〉0.05。在轻、中、重、极重COPD患者MP IgM的检出率分别为15.8%（3/19）,15.4%（2/13）、21.4%（3/14）、21.4%（3/14）;CP IgM的检出率分别为5.3%（1/19）、15.4%（2/13）、21.4%（3/14）、14.3%（2/14）。[结论]MP和CP IgM抗体在免疫功能正常和异常的AECOPD患者的检出无明显不同;MP和CP感染是AECOPD的重要病原体,但与COPD的免疫功能异常和严重程度无关。

[ Objective ] The purpose of this study is to test the detectable rate of pneumonia mycoplasma and Chlamydia in acute exacerbation of chronic obstructive pulmonary diseases （AECOPD） with immunocompetent and immunoincompetent patients. [ Methods] Sixty inpatients whose clinical features and chest lung function tests that confirmed AECOPD were involved from Dec. 2007 to Mar. 2008. IgA,IgM,IgG,C3, C4 and et al were tested in all of the patients. If anyone of the tested items in a patient was lower than normal, the patient would be considered as the immunoincompetence. With this classification, 20 patients were identified in the immunoincompetent group with age of （76.3 ± 6.6） years old in average. The other patients were grouped as control with age of （69.7 ± 10.1 ） years old in average. Blood was sampled from all patients in first and seventh day, and the IgM antibodies of mycoplasma pneumonia （MP） and chlamydia pneumonia （CP） were examinated using ELISA. [ Results] The detectable rates of MP and CP IgM were 25.0% （5/20）, 15.0% （3/20） respectively in the immunoincompetent group, and 15.0% （6/40）, 12.5% （5/40）in the control group. We ranked the COPD with four grades by lung function tests. The detectable rates of MP IgM in the four grades were 15.8% （3/19）, 15.4% （2/13） ,21.4% （3/14） ,21.4% （3/14） respectively, and those of CP IgM were 5.3% （ 1/19）, 15.4% （2/13）, 21.4 % （3/14 ） , 14.3 % （ 2/14 ） respectively. [ Conclusion ] There isn＇ t significant difference in the detectable rate of MP and CP IgM between the immunoineompetent and immunocompetent groups of AECOPD, although mycoplasma and chlamydia pneumonia were the common pathogen.