检测颅脑损伤合并肺部感染患者呼吸道病原体IgM抗体谱的临床价值

Clinical value of respiratory pathogens Ig M antibodiy in intracranial injury patients with pulmonary infection

目的分析颅脑损伤并发肺部感染住院患者的11种呼吸道病原体Ig M抗体联合检测结果,为临床及时制定治疗方案和合理使用抗菌药物提供依据。方法应用间接免疫荧光法检测2014年12月至2015年12月安徽中医药大学第一附属医院神经外科151例颅脑损伤合并肺部感染患者血清中11种呼吸道病原体Ig M抗体谱,分析11种病原体感染分布情况及其在性别、年龄和季节方面流行病学特征,并对其中38例进行动态检测。结果 151例患者中有82例(54.30%)至少检出1种呼吸道病原体Ig M抗体,其中男性60例(55.56%),女性22例(51.16%),男女阳性率比较差异无统计学意义(P>0.05);82例中34例感染1种,34例感染2种,14例感染3种及以上呼吸道病原体。感染阳性率前5位的呼吸道病原体依次是流感病毒B型、流感病毒A型、嗜肺军团菌、柯萨奇病毒A型、肺炎支原体,不受性别、年龄和季节的影响。动态检测的38例患者中,21例检测到病原体Ig M抗体,经过治疗后抗体滴度逐渐降低。结论对病原体Ig M抗体谱进行动态检测,有助于进一步明确诊断和疗效观察。

Objective To analyze respiratory pathogens IgM antibodyin intracranial injury patients with pulmonary infection, and provide guidance for clinical treatment. Methods A total of 11 respiratory pathogens of IgM antibodies in the serum of 151 patients were de-tected by usingindirect immunofluorescence test. The distribution of pathogens and their epidemiological characteristics in the sex, age and season were analyzed. Thirty - eight cases of them were dynamically detected. Results There were 82 cases （ 54. 30% ） which showed re-spiratory pathogens IgM antibodyies, including 60 （55.56%） males and 22 （51.16%） females, and there was no difference in male and fe-male. Thirty -fourpatients showedjust one kind respiratory pathogens antibody, thirty - four cases showedtwokinds respiratory pathogens anti-bodies, and fourteencases showed at least three kinds respiratory pathogens antibodies. The top five major respiratory pathogens were INFB, INFA, LP, COXA and MP. There was nostatistical significance in rate of respiratory infection positive rate in differentseasons. In the dynam-ic detection of 38 patients, 17 had no change, and the antibody titer in other 21 cases was gradually reduced. Conclusion The dynamic de-tection of pathogens IgM antibody spectrummay help to further clarify the diagnosis and observe the curative effect.