呼吸道感染488例非典型病原体及病毒IgM抗体检测分析

Detection Analysis of IgM Antibody of Atypical Pathogens and Viruses in 488 Adult Patients with Respiratory Tract Infection

目的了解呼吸道感染患者非典型病原体及病毒IgM抗体检测情况，以期指导临床治疗。方法对2012年2月1日-2013年5月31日北京军区总医院呼吸内科收治的呼吸道感染488例采用间接免疫荧光法（IIF）定性检测9种呼吸道常见病原体及病毒嗜肺军团菌（LP）、肺炎支原体（MP）、贝氏柯克斯体（Cb）、肺炎衣原体（CP）、腺病毒（ADV）、呼吸道合胞病毒（RSV）、流感病毒A（FluA）、流感病毒B（FluB）、副流感病毒（PIV）IgM抗体，对检测结果进行分析。结果488例9种呼吸道病原体及病毒IgM抗体阳性总检出率为57．0％，两种及以上混合感染阳性检出率为13．9％，其中以FluAIgM抗体阳性检出率最高；春季和冬季FluAIgM抗体阳性检出率均显著高于夏秋季（P〈0．01），春季LPIgM抗体阳性检出率高于秋季（P〈0．01），其他病原体及病毒不同季节间IgM抗体阳性检出率差异无统计学意义（P〉0．05）；不同病种间呼吸道病原体及病毒IgM抗体阳性检出率比较差异无统计学意义（P〉0．05）。15～65岁年龄段LP及MPIgM抗体阳性检出率高于65～99岁年龄段（P〈0．05）。结论非典型病原体及病毒是呼吸道感染的重要病原，混合感染是其显著特点。临床医师除掌握其特点外，还应重视季节、年龄等因素的影响，以更好地制订临床治疗方案。

Objective To study the detection results of IgM antibody of atypical pathogens and viruses in aduh patients with respiratory tract infection so as to guide the clinical treatment. Methods Nine common pathogens and viru- ses in respiratory tract infections such as legionella pneumophila （LP）, mycoplasma pneumoniae （MP）, coxiella burnetii （Cb） chlamydia pneumoniae （CP） , adenovirus （ADV） , respiratory syncytial viruses （RSV） , flu virus A （FluA） , flu virus B （FluB） and parainfluenza virus （PIV） in 488 adult patients with respiratory tract infections between February 1, 2012 and May 31, 2013 were detected with indirect immunofluorescence assay （IFA）. Results In the 488 patients, the total positive detection rate of IgM antibody of the nine pathogens and viruses was 57.0% , and mixed positive detection rate of two or more was 13.9% , in which FluA-IgM antibody was the highest one; the positive detection rates of FluA- IgM antibody in spring and winter times were significantly higher than those of summer and autumn times （P 〈 O. 01 ） , the positive detection rate of LP-IgM antibody in spring time was higher than that of autumn time （ P 〈 0. 01 ） , but the positive detection rates of IgM antibodies of other pathogens and viruses in different seasons showed no statistical differ- ences （P 〉 O. 05 ） ; the positive rates of IgM antibodies of pathogens and viruses in different diseases showed no statistical differences （P 〉 0.05）. The positive detection rates of MP and LP-IgM antibodies in 15-65 age group were higher than those in 65-99 age group （P 〈 0. 05）. Conclusion Atypical pathogens and viruses are the important pathogens in pa- tients with respiratory tract infection, which often goes with the mixed infections. Clinicians should be well aware of the characteristics and other factors of the infection such as seasons and ages in order to better guide clinical treatment.