九项呼吸道病原体IgM抗体联合检测对儿童呼吸道感染的临床意义

Clinical Significance of Detecting Immunoglobulin-M of Nine Pathogens in Serum of Children with Respiratory Tract Infection

目的 探讨九项呼吸道病原体IgM抗体联合检测对治疗儿童呼吸道感染的指导意义。方法 采用间接免疫荧光法检测2014年7月-2015年1月1 104例0-14周岁住院呼吸道感染患儿血清中九种病原体IgM,其中包括嗜肺军团菌-IgM（LP-IgM）、肺炎支原体-IgM（MP-IgM）、Q热立克次体-IgM（COX-IgM）、肺炎衣原体-IgM（CP-IgM）、腺病毒-IgM（ADV-IgM）、呼吸道合胞病毒-IgM（RSV-IgM）、甲型流感病毒-IgM（IFA-IgM）、乙型流感病毒-IgM（IFB-IgM）、副流感病毒1,2-IgM和3型（PIVS-IgM）,记录患儿信息和检测结果,用统计学软件SPSS进行卡方检验。结果1 104例患儿中病原体新近感染率为38.32%（423/1 104）,其中CP-IgM阳性率最高为28.44%,其次乙型流感病毒-IgM为9.51%,混合感染率为26.24%,以肺炎支原体并发乙型流感病毒感染为主。总阳性感染人数中男性阳性率为36.40%（218/599）,女性阳性率为40.60%（205/505）,性别间差异无统计学意义（χ^2=2.05,P=0.15）。结论 九项呼吸道病原体IgM抗体联合检测具有操作简便,费用低,检测迅速和被检范围广等优点,对儿童呼吸道感染病原菌具有早发现、早诊断及早治疗的临床应用价值。

Objective To explore the guiding significance of detection of IgM of nine respiratory tract infection pathogens in the treatment of children with respiratory infection. Methods Collected 1 140 cases of 0-14 years old children with respiratory tract infection from July 2014 to January 2015 in Shaanxi Provincial People＇s Hospital. The IgM antibodies of nine pathogens including Legionella pneumophila （LP）, Mycoplasma pneumophila （MP）, Coxiella burneti （COX）, Chlamydia pneumophila （CP）, adenovirus （ADV）, respiratory syncytial virus （RSV）, influenza A virus （IFA）, influenza B virus （IFB） and parainfluenza virus type 1,2 and 3 （PIVS） was detected by indirect immunofluorescence technique with nine respiratory joint inspection reagent. Results The total positive rate of IgM was 38. 32% （423/1 104） in 1 104 cases of respiratory tract infection patients and the highest one was 28. 44% of Mycoplasma pneumophila-IgM followed by influenza B virus-IgM （9.51%）. The IgM positive rate of mixed pathogens was 26.24% in which Mycoplasma pneumophila-IgM combined influenza B virus-IgM was in the majority. The positive rate of male patients was 36.40% （218/599） ,and that of females was 40.60% （205/505）. There was no statistical difference between males and females （χ^2=2.05,P=0.15）. Conclusion The detection of IgM antibodies of nine respiratory tract infection pathogens is simple,low cost, rapid and highly accurate, which has positive value for clinical application in the treatment of children with respiratory infection.