呼吸道九联检在小儿急性呼吸道疾病诊断中的临床价值

Clinical significance of the detection of nine respiratory pathogens for the diagnosis of pediatric acute respiratory diseases

目的探究呼吸道九联检在小儿急性呼吸道疾病诊断中的临床价值。方法选择海口市妇幼保健院2012年6月至2014年6月共6 122例小儿急性呼吸道疾病患儿,其中0~1岁患儿2 397例归为婴儿组,1-3岁患儿1 848例归为幼儿组,3~8岁患儿1 877例归为儿童组,并采用九联检试剂间接免疫荧光法对3组患儿的病原体抗体进行检测,其中包括肺炎支原体（MP）、呼吸道合胞病毒（RSV）、乙型流感病毒（IFB）、腺病毒、嗜肺军团菌血清1型、肺炎衣原体（CP）、甲型流感病毒（IFA）、副流感病毒（PIVS）和Q热立克次体（QFR）9种病原体。结果通过对3组患儿的病原体种类分布情况比较分析发现,不同年龄段的患儿感染病原体不同,婴儿组和幼儿组主要以病毒感染最为主,主要感染为IFB,而儿童组则主要以支原体感染较为多见,主要为MP。婴儿组在MP、RSV、IFB、CP、IFA和PIVS上与儿童组相比差异有统计学意义（P〈0.05）。在3组患儿的9种病原体抗体的阳性检测率中发现,婴儿组和幼儿组阳性率较儿童组阳性率明显偏高,差异有统计学意义（P〈0.05）。结论呼吸道九联检对小儿急性呼吸道疾病的病原体的种类、流行病学特点及早期诊断、治疗具有很大的帮助,临床工作中值得广泛应用。

Objective To investigate the clinical value of the detection of nine respiratory pathogens for the diagnosis of pediatric acute respiratory diseases.Methods From June 2012 to June 2014,6 122 cases of children with acute respiratory diseases were selected in Maternal and Child Health Hospital of Haikou and divided into three age groups：infant group including 2 397 cases of children from 0to 1,toddler group including 1 848 cases of children from 1to 3,and children group including 1 877 cases of children from 3to 8.Antibodies of nine kinds of respiratory pathogens of three groups were detected by indirect immunofluorescence assay（IFA）,including Mycoplasma pneumoniae（MP）,respiratory fit package virus（RSV）,influenza B virus（IFB）,adenovirus,Legionella pneumophila serotype 1,Chlamydia pneumoniae（CP）,influenza virus（IFA）,parainfluenza virus（PIVS）,and Q fever rickettsia（QFR）.Results Through the comparative analysis of the distribution of the pathogens among three groups,it was found that virus infection was common in infant group and toddler group,with FIB as the main pathogen,and mycoplasma infection was common in children group,with MP as the main pathogen.Comparing with children group,the positive rates of MP,RSV,IFB,CP,IFA and PIVS were significantly different（P〈0.05）.Among three groups,the positive rates of nine kinds of antibodies of respiratory pathogens in infant group and toddler group were significantly higher than children group,with statistical difference（P〈0.05）.Conclusion The detection of nine kinds of respiratory pathogens was helpful in understanding the pathogen species,epidemiological characteristics,early diagnosing and treating,which was worthy of spreading in clinic.