喘息性疾病患儿血清九种呼吸道病原体IgM抗体检测研究

Study on detection of IgM antibodies of 9 types of respiratory pathogen infection in children with asthmatic diseases

目的探讨9种呼吸道感染病原体与桂北地区儿童喘息性疾病的相关性,为临床诊断和治疗提供参考。方法选取2011年3月～2012年12月桂林医学院附属医院儿科收治的喘息性疾病患儿756例,采用间接免疫荧光法检测血清中9种呼吸道感染病原体IgM抗体,并进行临床分析。结果 756例喘息性疾病患儿中,检测出呼吸道感染病原体IgM抗体阳性342例,阳性率为45.2%,其中肺炎支原体(MP)的阳性率最高(40.0%),其次为乙型流感病毒(ifuB)(7.0%),呼吸道合胞病毒(RSV)和噬肺军团菌1型(LP)阳性率为第3、4位,阳性率分别为4.0%和3.8%,腺病毒(Adv)阳性率为2.8%。本地区喘息性疾病儿童感染MP季节差异无统计学意义(P>0.05),RSV在春季检出率较高,ifuB在冬季和春季检出率较高。47例患儿同时检测出2种以上非典型病原体,且主要为MP与其他病原体的混合感染(41/47,87.2%)。8 d～6个月组IgM抗体的总检出率为16.3%,明显低于其他年龄组,差异有统计学意义(P<0.05)。喘息性支气管炎病原体IgM抗体检出率最高(66.4%),其次为支气管哮喘合并感染(61.0%),最低为毛细支气管炎(39.0%),差异有统计学意义(P<0.05)。结论桂北地区儿童喘息性疾病与感染关系密切,主要病原体是MP、ifuB、RSV和LP;MP和其他病原体的混合感染比较常见。

Objective To investigate the association of 9 types of respiratory pathogens with asthmatic diseases in chil dren in the north area of Guilin,and to provide information for clinic.Methods Indirect immunofluorescence assay was used to detect IgM antibodies against 9 types of respiratory pathogens in the sera of 756 children with asthmatic diseases in the Hospital Affiliated to Guilin Medical College from March 2011 to December 2012,and clinical analysis was taken.Results Of the 756 children with asthmatic diseases,342 cases（45.2%）were found had positive IgM anti bodies against respiratory pathogens,Mycoplasma pneumonia（MP） was most common（40.0%）,it was followed by In fluenza virus B（ifuB）（7.0%）,the positive rate of virus RS（RSV） was 4.0%,Legionella pneumophile（Lp） was 3.8%,adenovirus（Adv） was 2.8%.There were no differences of the positive rates of MP in difference seasons（P 0.05）.The positive rate of RSV was higher in spring,and then that of ifuB was in winter and spring,47 cases were found suffered from co-infection of two or more pathogens,mainly comprising MP and other pathogens（41/47,87.2%）.There were significant differences in the total detection rate of IgM antibodies among all age groups,the positive rate of children in 8 days to 6 months was lower than that in other groups,the differences were statistically significant（P 0.05）.The positive rate of IgM antibodies against respiratory pathogens was highest in children with asthmatic bronchitis（66.4%）,followed by children with bronchial asthma（61.0%）,and it was lowest in children with bronchiolitis（39.0%）.Conclusion There are close association of infection with asthmatic diseases in children in the north area of Guilin,the main respiratory pathogens include MP,ifuB,RSV and LP,co-infection of MP and other pathogens is common.