重症手足口病患儿合并肺炎支原体感染实验室检测指标对于临床诊断及治疗的提示性作用

Value of laboratory indicators for clinical diagnosis and treatment of the patients with severe hand, foot and mouth disease complicated with Mycoplasma pneumoniae infection

目的探讨肠道病毒71型合并肺炎支原体感染的重症手足口患儿的检测指标对于临床诊断及治疗是否起到提示作用。方法收集2014年3月至8月于首都医科大学附属北京地坛医院住院的手足口病患儿100例,非手足口病患儿50例,对其粪便标本采用荧光定量RT-PCR方法检测,得出核酸定性结果。对其血清标本采用被动凝集法检测以得出肺炎支原体抗体效价。分析肺炎支原体感染在手足口病组和非手足口病组中的差异,探讨肠道病毒71型合并肺炎支原体感染与手足口病严重程度的相关性。结果重症手足口病组患儿的肺炎支原体阳性率(76%)高于轻症手足口病组患儿的肺炎支原体阳性率(48%),差异有统计学意义(χ2=8.319,P=0.004)。结论肠道病毒71型阳性合并肺炎支原体感染的重症手足口病患儿,应在临床诊治中引起关注。对于降低重症手足口病患儿向危重症的转化具有提示意义。

Objective To investigate the value of laboratory indicators in clinical diagnosis and treatment of the patients with severe hand, foot and mouth disease （ HFMD ） commplieated with enterovirus 71 （ EV71 ） and Mycoplasma pneumortiae infection. Methods The data of 100 cases with HFMD and 50 cases with non-HFMD were collected in Beijing Ditan Hospital from March 2014 to August 2014. Real-time fluorescence quantitative PCR（RT-PCR） method was used to test the DNA in stool samples and obtained qualitative results. Passive agglutination test was performed to detect Mycoplasma pneumoniae antibody titers in serum. Then, we analyzed the possibility of Mycoplasma pneumoniae infection in HFMD group and non-HFMD group, and explored the correlation of EV71 infection complicated with Mycoplasma pneumoniae infection and the severity of HFMD. Results The positive rate of Mycoplasma pneumoniae infection in the severe HFMD group（76% ） was significantly higher than that in the mild HFMD group（48%, χ^2= 8. 319, P= 0. 004）. Conclusion Close teention should be paid to severe HFMD patients with the EV71 infection complicated with Mycoplasma pneumoniae infection. This is critically important for reducing the severity of HFMD.