呼吸道病毒和非典型病原体与下呼吸道感染的相关性研究

Correlation Between Lower Respiratory Tract Infection and Respiratory Viruses,Atypical organisms

目的探讨成人下呼吸道感染患者中常见呼吸道病毒和非典型病原体的感染状况。方法采集2006年1月-2009年4月195例下呼吸道感染患者的支气管肺泡灌洗液(BALF),采用多重PCR技术检测常见的7种(11个亚型)呼吸道病毒和肺炎支原体(LP)、肺炎衣原体(CP)、嗜肺军团菌(LP)。其中62例同时采集BALF、鼻咽拭子(NpS)和血清三种标本进行病原体检测。结果 195例BALF 65例阳性,患者阳性率33.3%(65/195),共检出72种(株)病原体,病原体阳性率36.9%(72/195),14种(型)病原体检出9种(型),以流感病毒A型(F luA)和鼻病毒(RhV)检出率为高,副流感病毒2型(PIV2)、副流感病毒4型(PIV4)、人类偏肺病毒(hMPV)、人类博卡病毒(HboV)和嗜肺军团菌(LP)未检出。患者以社区获得性肺炎(CAP)和慢性阻塞性肺病急性发作期(AECOPD)阳性率高。62例同时三种标本检测阳性率NpS为50.0%(31/62)、BALF 38.7%(24/62)、血清32.3%(20/62)。结论深圳地区成人下呼吸道感染中病毒感染具有较高比例,以F luA和RhV为主。BALF和NpS非典型病原体检出率较低,所有标本均未检测出hMPV、HboV和LP。

Objective To investigate the infection rate of respiratory virus and atypical bacteria in adult patients with lower respiratory tract infection. Methods Bronchoalveolar lavage fluid（BALF） was sampled from 195 patients with lower respiratory tract infection from January 2006 to April 2009.7 kinds of respiratory viruses（11 typings）,Mycoplasma pneumoniae（MP）,Chlamydia pneumoniae（CP） and Legionella pneumophilia（LP） were detected in all the patients by multiplex PCR.BALF,serum and nasopharyngeal swab（NpS） samples were also detected in 62 patients among them. Results The positive rate of BALF was 33.3%（65/195）.72 strains of pathogens were detected,with the positive rates of 36.9%（72/195）.9 of 14 typings were detected.Most of the positive viruses were influenza A virus（FluA） and human rhinovirus（RhV）.Parainfluenza virus II,parainfluenza virus Ⅳ,human metapneumovirus,human Boca virus（HboV） and LP were not detected.The positive rate was higher among the patients with community-acquired pneumonia（CAP） or chronic obstructive pulmonary disease exacerbation（AECOPD）.The positive viruses rates of NpS,BALF and serum samples in the 62 patients were 50.0%（31/62）,38.7%（24/62） and 32.3%（20/62）,respectively. Conclusions The virus infection rate was relatively higher in lower respiratory tract infection in Shenzhen area,most of which were FluA and RhV.The detection rates of atypical pathogens from BALF or NpS samples were both lower.No HboV,hMPV and LP was detected from all the samples.