病原学检测应用于婴幼儿肺炎的评价

Evaluation of pathogen detection used in infantile pneumonia

目的:评价病原学检测在婴幼儿肺炎中的应用价值。方法:用循证医学系统评价的方法,对我国婴幼儿肺炎的主要流行病学特征和目前呼吸道病原学检测在婴幼儿肺炎中的应用进行评价。结果:(1)婴幼儿肺炎的流行病学特点随研究的年代、季节、地区的不同而变化,也因所选病例的年龄组不同而有差异,同时也受病原学检测方法和判断标准的影响。(2)肺炎病原学检测标本常用的包括鼻咽分泌物、痰、支气管肺泡灌洗液或血清。(3)检测包括细菌、病毒、非典型菌等。(4)检测方法包括常规细菌培养、直接分离病原体、酶联免疫吸附法(ELISA)、采用间接免疫荧光法(IFT)、荧光定量PCR(FQ-PCR)和逆转录(RT)-PCR方法。(5)我国婴幼儿肺炎病原体分布仍以细菌感染多见,而呼吸道病毒、非典型菌感染亦不容忽视。结论:婴幼儿肺炎不同年龄阶段的临床表现各有特点,致病原也存在一定差异。呼吸道病原检测所需的仪器简单,标本容易收集,检测的灵敏度和特异性均较高,有临床推广意义。

Objective：To evaluate the application value of the pathogen detection in infantile pneumonia.Methods：Using the evidence-based medicine method,the main epidemiological characteristics of infantile pneumonia and the application of respiratory pathogen detection in infantile pneumonia were evaluated.Results：（1）The epidemiological characteristics of infantile pneumonia were changed with the different study times,seasons,areas and selective age groups,which were affected by the pathogen detection methods and the evaluation standards.（2）The commonly used test specimens in pneumonia pathogen detection included nasopharyngeal secretions,sputum,bronchoalveolar lavage fluid or serum.（3）The detections included bacteria,viruses and atypical bacteria.（4）The detection methods included the routine bacterial culture,direct separation of pathogens,ELISA,indirect immunofluorescence（IFT）,fluorescence quantitative PCR（FQ-PCR） and reverse transcription（RT）-PCR methods.（5）Bacterial infections in the pathogens distribution of infantile pneumonia was still relatively common,and respiratory virus,atypical infection should not be overlooked.Conclusion：The clinical manifestations of infantile pneumonia are different in different ages and pathogens have some differences.The required equipment of the respiratory pathogen detection is simple and easy to collect samples with high sensitivity and specificity,which has a significance to be popularized in clinic.