强直性脊柱炎患者呼吸道病原微生物感染分析

Analysis of Respiratory Pathogens in Patients with Ankylosing Spondylitis

目的临床调查导致强直性脊柱炎(ankylosing spondylitis,AS)患者呼吸道感染的病原微生物。方法咽拭子培养和血清学方法对156例AS患者进行细菌、肺炎支原体、肺炎衣原体、EB病毒等进行检测,血清学方法设置对照组。并收集病人的疾病活动性资料,如疾病活动指数(BASDAI)、血沉(ESR)和C反应蛋白(CRP)等。结果 156例AS患者细菌感染率为7.7%,急性肺炎支原体感染率(36.5%)明显高于正常人(20.5%,P<0.01),肺炎衣原体感染率(55.1%),亦高于正常人(34%,P<0.01)。但IgA抗肺炎支原体(MpIgA)和IgA抗肺炎衣原体抗体(CpIgA)与AS患者的疾病活动指标没有明显的关系。EB病毒和巨细胞病毒感染在AS患者和正常人之间差异无统计学意义。结论肺炎衣原体和肺炎支原体是引起AS患者呼吸道感染主要的病原微生物。

Objective To clinically investigate the respiratory pathogens among the patients with ankylosing spondylitis（AS）. Methods One hundred and fifty-six AS patients were investigated for pathogenic microbes by ELISA methods,including culture of throat swab,and determination of IgA or IgG to Chlamydia pneumoniae（CP）,Mycoplasma pneumoniae（MP）,Epstein Barr virus（EB） and cytomegalovirus（CMV）.Another 112 healthy individuals were served as the control group.The patients＇ activity data were collected,including BASDAI,ESR,and CRP. Results The bacterial infection rate of 156 AS patients was 7.7%.The infection rate of acute mycoplasma pneumonia（36.5%） was significantly higher than that of the healthy individuals（20.5%,P〈0.01）.The infection rate of chlamydia pneumonia（55.1%） was also higher than that of the healthy individuals（34%,P〈0.01）.There was no significant relationship between clinical manifestations and MpIgA,CpIgA in AS patients.No statistically significant difference was found in EBV and CMV infection between AS patients and healthy individuals. Conclusions Chlamydia pneumoniae（Cp） and Mycoplasma pneumoniae（Mp） are the major pathogens responsible for upper respiratory infection in AS patients.