9种呼吸道病原体IgM抗体联合检测的临床意义

The clinical value of combining detection of 9 atypical pathogens in patients with respiratory tract infedtions

目的了解9种非典型性病原体在呼吸道感染患者中感染率,探讨9种非典型性病原体IgM抗体联合检测在呼吸道感染中的临床意义。方法收集681例呼吸道感染患者(其中成人277例,儿童404例)血清,采用间接免疫荧光法(IFA)同时检测嗜肺军团菌(Lp)、肺炎支原体(Mp)、Q热立克次体(QFR)、肺炎衣原体(Cp)、腺病毒(ADV)、呼吸道合胞病毒(RSV)、甲型流感病毒(IAV)、乙型流感病毒(IBV)和副流感病毒(PIV)9种呼吸道病原体的IgM抗体。结果 1、681例样本中共检测出IgM抗体阳性258例(感染率37.89%),其中成人79例(感染率28.51%),儿童179例(感染率44.31%);各病原体IgM抗体阳性例数和感染率从高到低依次为:Mp 25.11%,IBV14.68%,PIV 1-3型3.96%,IAV 1.91%,Lp 1.76%,RSV1.47%,ADV 0.44%,QFR和CP无感染。2、在所有感染病例(IgM抗体阳性)中,九种病原体所占构成比依次为:Mp 51.20%,IBV 29.60%,PIV 1-3型7.78%,IAV 3.89%,Lp 3.59%、RSV 2.99%、ADV 0.90%。3.在258例感染样本中,混合感染占71例(27.52%)。结论九种非典型性病原体中,肺炎支原体感染率最高;呼吸道病原体IgM抗体联合检测可以在早期快速同时检测出多种病原体,为临床对呼吸道感染患者的早期诊断、治疗提供科学依据。

Objective To explore the infectious rates of 9atypical pathogens in patients with respiratory tract infedtions（RTI）and investigate its clinical value.Methods 681 patients with respiratory tract infection were enrolled,and their fasting serum samples were collected.Indirect immunofluorescence was employed to conduct joint detection for Legionella pneumophila 1（LP1）,Mycoplasma pneumoniae（MP）,Coxiella burnetii（COX）,Chlamydia pneumoniae（CP）,adenovirus（ADV）,respiratory syncytial virus（RSV）,influenza A virus（IFA）,influenza B virus（IFB）,parainfluenza virus（PIV）in respiratory tract.Results Among 681 patients with RTI,258 cases was detected positively,which accounted for 258 cases with the infection rate of 37.89%（258/681）,including 79 positive cases in adults with the infectious rate 28.51% and 179 positive cases in children with the infectious rate 44.31%;Mp infection was predominant and the positive rate was 25.11%,and the positive rates of IBV,PIV 1-3,IAV,Lp,RSV,ADV,QFR and CP were14.68%,3.96%,1.91%,1.76%,1.47%,0.44%,0% and 0% respectively.Ammon the 9atypical pathogens,the percentage of MP,IBV,PIV 1-3,IAV,Lp,RSV and ADV were 51.20%,29.60%,7.78%,3.89%,3.59%,2.99%,0.90%respectively.The mixed infection rate accounted for 27.52%,and Mp combined with FluB were most common with the rate of 49.3%.Conclusion Ammon the 9atypical pathogens MP has the highest positive infection rate.Combining detection of 9atypical pathogens can detect several pathogens in patients with acute respiratory tract infedtions fast early at the same time,and can provide scientific evidence for clinical early diagnosis and treatment to the patients with acute respiratory tract infedtions.