肺炎衣原体感染与支气管哮喘的发病关系

Preliminary clinical study on the association of chlamydia pneumoniae infection and exacerbation of asthma

目的 :研究哮喘患者的肺炎衣原体感染状况 ,并探讨肺炎衣原体感染在哮喘发病中的作用。 方法 :对 75例哮喘及 6 3例呼吸道感染者进行研究 ,以 10 0例献血员血标本作为健康对照。应用聚合酶链反应 ( PCR)和直接免疫荧光法检测咽拭子标本中的肺炎衣原体 ,以及微量免疫荧光法 ( MIF)检测血清肺炎衣原体 Ig G、Ig M和 Ig A抗体。 结果 :哮喘组肺炎衣原体 Ig G抗体阳性率 ( 81.3% )显著高于献血员组 ( 6 8.0 % ) ,P<0 .0 5 ,与感染组无统计学差异 ( 6 9.8% ) ,P>0 .0 5 ;发作期哮喘组肺炎衣原体感染率 ( 5 9.4% )显著高于呼吸道感染组 ( 34.9% ) ,P<0 .0 5 ;哮喘组肺炎衣原体 Ig G抗体平均滴度 ( 48.38± 6 .94)显著高于呼吸道感染组 ( 2 4.70± 8.77) ,P<0 .0 5 ;但 Ig A抗体平均滴度差异不显著 ;肺炎衣原体感染的哮喘患者中 5 7.1% ( 12 / 2 1)同时存在其他病原体 ;对证实有肺炎衣原体感染的 7例哮喘患者进行抗肺炎衣原体治疗有效。 结论

Objectives:To determine the possible association of Chlamydia pneumoniae (C. pneumoniae) infection and asthma exacerbation. Methods:A prospective study of C.pneumoniae infection was conducted in 75 patients with asthma and 63 patients with respiratory tract infection , and 100 blood donors served as controls. The presence of infection was convinced by the polymerase chain reaction and direct immunofluorescence assay for C.pneumoniae DNA from throat swab specimens and microimmunofluorescence testing for C.pneumoniaespecific IgG, IgM and IgA antibodies. Results:Prevalence of specific IgG in asthma patients(81.3%)was higher than that of blood donors (68.0%, P<0.05)and was not significantly different from respiratory tract infection patients(68.0%, P>0.05). The acute C. pneumoniae infection rate of symptomatic asthma patients(59.4%)was markedly higher than respiratory tract infection patients(34.9%, P<0.05). The average titer of C. pneumoniae IgG instead of IgA in asthma patients(48.38± 6.94 )was significantly higher than respiratory tract infection patients(24.70±8.77,P< 0.05 ). Other pathogens were identified in 12 of 21 (57.1%) asthma patients with C. pneumoniae. The symptoms of 7 asthma patients with C. pneumoniae infection were improved through antibiotic treatment for C. pneumoniae infection. Conclusions: The findings suggest a possible role for C. pneumoniae infection in asthma.