儿童急性间质性肺炎病原体感染检测结果分析

Pathogens for acute interstitial pneumonia: an analysis on 20 children

目的对儿童急性间质性肺炎(acute interstitial pneumonia,AIP)肺组织行致病病原体鉴定,以明确儿童AIP致病原因。方法回顾性分析2002年1月至2018年10月重庆医科大学法医学教研室(重庆法医验伤所)儿童间质性肺炎的尸体解剖资料并筛选样本;参照美国胸科协会/欧洲呼吸学会发表的临床-影像-病理诊断标准确诊为AIP的20例患儿作为AIP组;非肺部疾病意外死亡的13例儿童作为对照组。通过免疫组化方法对两组肺组织分别进行呼吸道合胞病毒(respiratory syncytial virus,RSV)、柯萨奇-腺病毒(coxsackie and adenovirus,CAV)、A型流感病毒、B型流感病毒、肺炎衣原体(chlamydia pneumonia,CMP)和Toll-2受体抗体检测,并进行统计学分析。结果 AIP组抗体阳性例数如下:RSV 10例,CAV 7例,A型流感病毒1例,B型流感病毒2例,TLR2 2例,CMP 1例。对照组中RSV 1例、CAV病毒2例、TLR2 2例、A型流感病毒1例、B型流感病毒1例;经统计学分析,两组RSV抗体阳性检出率有统计学意义(P<0.05),其余病原体抗体检出率无统计学意义(P>0.05)。结论呼吸道合胞病毒可能是儿童急性间质性肺炎的致病病原体。

Objective To detect the pathogens causing acute interstitial pneumonia(AIP) in children in order to identify the pathogenesis of the disease. Methods We retrospectively analyzed the autopsy data from 95 children with idiopathic interstitial pneumonia examined in our department between January, 2002 and October, 2018. We collected tissue samples from 20 children with a definite diagnosis of AIP based on the criteria of the European Respiratory Society(ERS) and American Thoracic Society(ATS), and from 13 children without lung diseases who died in accident as the control group. The antibodies of respiratory syncytial virus(RSV), Coxsackie and adenovirus(CAV), influenza A virus, influenza B virus, Toll-like receptors 2(TLR-2) and chlamydia pneumoniae(CMP) in the tissue samples were detected using immunohistochemistry. Results In the 20 children with AIP, 10 were positive for RSV, 7 for CAV, 1 for influenza A virus, 2 for influenza B virus, 1 for CMP and 2 for TLR-2 antibody;in the control group, 1 child was positive for RSV, 2 for CAV, 1 for influenza A virus, 1 for influenza B virus, and 2 for TLR-2 antibody. The positive rate of RSV antibody differed significantly(P<0.05) while the antibodies of other pathogens did not show significant difference(P>0.05) between the 2 groups. Conclusion RSV infection is a probable pathogen causing AIP in children.