儿童呼吸道感染病原体IgM抗体与超敏C-反应蛋白和白细胞联合测定的临床意义

The significances of pathogen IgM antibody,high sensitivity C-reactive protein and white blood cell count in children with respiratory tract infection

目的探讨儿童呼吸道感染患者9种呼吸道病原体感染情况及其与hs-CRP、白细胞总数和白细胞分类的关系,为临床诊疗提供依据。方法采集诊断为呼吸道感染的606例儿童患者血清,采用间接免疫荧光法检测9种呼吸道感染病原体的IgM抗体,日立7600全自动生化分析仪检测hs-CRP和迈瑞BC-6800血细胞分析仪检测白细胞总数及分类,并对结果进行分析。结果 606例标本中,164份标本病原体IgM抗体阳性,总阳性率为27.06%。9种病原体的检出率由高到低依次为MP(17.49%)、Flu B(7.92%)、LP1(7.43%)、ADV(0.99%)、PIV(0.83%)、COX(0.50%)、CP(0.33%)、Flu A(0.00%)、RSV(0.00%)。混合感染中,2种混合感染41例,3种混合感染5例,未见4种及4种以上混合感染,混合感染中共有39例为MP合并其他感染,占混合感染的84.78%。在单独病原体阳性患者中,Flu B阳性组WBC显著低于阴性组和MP阳性组(P<0.05),Flu B阳性组的NEUT%和hs-CRP显著低于MP阳性组、LP1阳性组和阴性组(P<0.05),Flu B阳性组的LYM%显著高于MP阳性组、LP1阳性组和阴性组(P<0.05),MP阳性组的MXD%显著低于Flu B阳性组、LP1阳性组和阴性组(P<0.05)。结论六安地区儿童呼吸道感染的病原体主要是MP、Flu B和LP1,MP和其他病原体的混合感染比较普遍,Flu B感染与WBC、NEUT%、LYM%以及hs-CRP水平相关,MP感染与MXD%相关。

Objective To detect pathogen IgM antibody in children with respiratory tract infection, and the relationship of pathogen IgM antibody, high sensitivity C- reactive protein and white blood cell count in children with respiratory tract infection, provide evidence for clinical diagnosis and treatment. Methods Nine kinds of pathogen IgM antibodies in serum of 606 children who were diagnosed as respiratory tract infection were tested by indirect immune-fluorescence assay, hs-CRP and white blood cell count were tested by automatic biochemistry analyzer and automatic blood cell analyzer respectively.Results The pathogen IgM antibodies were found positive in 165 specimens （27.23%）. The detection rates of the nine pathogens ranged from high to low were MP（17.49%）, Flu B（7.92%）, LP1（7.43%）, ADV（0.99%）, PIV（0.83%）, COX（0.50%）, CP（0. 33% ） , Flu A（ 0.00% ） , RSV（ 0.00% ）. 41 cases were infected by 2 kinds of pathogens and 5 cases were infected by 3 kinds of pathogens, none case infected by 4 and more than 4 pathogens. 39 cases were infected by MP combined with other pathogens, accounted for 84.78% of mixed infection. The white blood cells in Flu B single positive group were significantly lower than pathogen negative group and MP single positive group （P〈 0. 05 ）, NEUT% and hs-CRP in Flu B single positive group were significantly lower than pathogen negative group, MP single positive group and LP1 single positive group （P〈0. 05 ）, LYM% in Flu B single positive group were significantly higher than pathogen negative group, MP single positive group and LP1 single positive group （P〈0. 05 ） , MXD% in MP single positive group were significantly lower than pathogen negative group, Llu B single positive group and LP1 single positive group （P〈 0. 05 ）. Conclusions The main pathogens in children with respiratory tract infection in Lu＇an area are MP, Flu B and LP1. Mixed infections of MP and other pathogens are common. Flu B infection was correlated with WBC, NEUT%, LYM% and hs- CRP levels, MP infection is associated with MXD%.