三种呼吸道标本检测急性呼吸道感染非细菌性病原体的比较

The Comparison on the Results of Non-bacterial Pathogens in Three Respiratory Specimens from the Patients with Acute Respiratory Infection

目的:选择适宜的呼吸道标本,以方便急性呼吸道感染非细菌性病原体病原学诊断应用。方法:采集急性呼吸道感染患者的鼻咽分泌物(NPS)、痰和支气管肺泡灌洗液(BLF)为检测标本,应用聚合酶链反应技术(PCR)检测腺病毒(ADV)、呼吸道合胞病毒(RSV)、肺炎衣原体(CP)和肺炎支原体(MP)4种非细菌性病原体,比较这3种呼吸道标本检测病原体结果的差异。结果:ADV、RSV、CP和MP的检出率,NPS标本分别为10.4%、29.2%、33.3%和18.8%,痰标本分别为10.4%、25.0%、35.4%和16.7%,BLF标本分别为8.3%、22.9%、27.1%和16.7%。上呼吸道感染和下呼吸道感染时,不同标本检测病原体的阳性率有一定的差别。结论:NPS、痰和BLF均可用做PCR检测急性呼吸道感染非细菌性病原体的标本,其中NPS容易获得、采集安全、能够满足病原学诊断需要,可以作为首选标本。

Objective： To choose the suitable respiratory specimens for the detecting of non - bacterial pathogens to facilitate the diagnosis of the etiology in acute respiratory infection （ ARI ）. Method： Nasopharyngeal secretion （NPS） , sputum and bronchoalveolar lavage fluid （BLF） were collected from the patients with ARI and make these three specimens for detecting . Adenovirus（ADV ）, Respiratory syncytial virus（RSV）, Chlamydia pneumonia （CP） and Mycoplasma pneumonia （MP） by polymerase chain reaction （PCR） to find the difference of results of detecting the three specimens. Result： The positive rate of ADV, RSV, CP and MP as 10.4%, 29.2%, 33.3% and 18.8% in NPS respectively; In sputum the rate was 10. 4%, 25.0%, 35.4% and 16.7% respectively; In BLF, the positive rate was 8.3%, 22.9%, 27.1% and 16.7% respectively. The positive rates had some difference in different samples for detecting in AURI and ADRI. The differences on the positive results of same pathogens were no statistics meaning among NPS, sputum and BLF （ P 〉 0.05 ）. Conclusion： NPS, BLF and sputum can all be used as specimens for detecting of non -bacterial pathogens by PCR in ARI and NPS may be the first choice for its advantage such as obtainable, safety for collecting and can satisfied the clinical need of diagnosis of etiology.