儿童急性呼吸道感染9种病原体IgM抗体检测结果分析

杨敏，刘诚，李耀军

（1.陕西省镇巴县人民医院检验科，陕西汉中，723600；2.陕西省城固县医院检验科，陕西汉中，723200；3.西安医学院第二附属医院检验科，陕西西安，710038）

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摘要：

目的 分析本地区儿童急性呼吸道感染的主要病原体及流行情况，为儿童呼吸道感染的诊疗提供依据。方法 采用间接免疫荧光法检测医院门诊及住院呼吸道感染患儿1510 例血清标本中：嗜肺军团菌血清1 型(LP1)、肺炎支原体(MP)、Q热立克次体(Qc)、肺炎衣原体(CP)、腺病毒(AdV)、呼吸合胞病毒(RSV)、甲型流感病毒(IFVA)、乙型流感病毒(IFVB)和副流感病毒(PIVs)等9种病原体的IgM 抗体的检出情况。结果 1510例患儿标本共检出阳性病例387例，阳性率为25.63%，共检出病原体483例。9种病原体IgM 抗体检测总阳性率最高的为MP 17.88%(270/1 510)、其次为IFVB 11.32%(171/1 510)，其余由高到低排列顺序为PIVS(1.59%)、CP(0.33%)、AdV(0.26%)、RSV(0.26%)、IFVA(0.26%)、LP1(0.20%)、Qc(0.13%);混合感染96 例占6.36%(96/1 510)，以MP+IFVB 最为常见占4.97%(75/1 510);不同性别检出阳性率比较无显著差异性(P>0.05);1~14岁均为易感儿童，与约1岁组比较差异有统计学意义(P<0.05);冬季检出阳性率最高，夏季最低，冬、夏季检出阳性率分别与其他季节比较，差异均有统计学意义(P<0.05)。结论 本地区急性呼吸道感染患儿以MP、IFVB为主，且MP+IFVB易合并感染，因此临床应做好儿童呼吸道感染的预防工作。

关键词：儿童急性呼吸道感染；病原体；IgM抗体

中图分类号：R725.6文献标志码：A文章编号：2096-1413(2017)05-0085-03

Analysis of IgM antibody test results of nine pathogens in children with acute respiratory infection

YANG Min, LIU Cheng, LI Yao-jun

(1. Clinical Laboratory, People’s Hospital of Zhenba County, Hanzhong 723600; 2. Clinical Laboratory, Chenggu County Hospital, Hanzhong 723200; 3. Clinical Laboratory, the Second Affiliated Hospital of Xi’an Medical College,Xi an 710038, China)

ABSTRACT: Objective To analyze the main pathogens and epidemic situation of children with acute respiratory infection in this region, and to provide evidence for the diagnosis and treatment of respiratory tract infection in children. Methods The indirect immunofluorescence assay was used to detect IgM antibody of nine pathogens in 1 510 cases children with acute respiratory infection in outpatient and inpatient department, including the legionella pneumophila serotype 1 strains(LP1), mycoplasma pneumonia (MP), rickettsia burneti (Qc), chlamydia pneumonia (CP), adenovirus (AdV), respiratory syncytial virus (RSV), influenza A virus (IFVA), influenza B virus (IFVB) and parainfluenza virus (PIVs). Results Threehundred and eighty-seven of 1510 cases of children were checked out as positive samples, the positive rate was 25.63%, a total of 483 pathogens were checked out. The highest-positive rate of nine pathogens IgM antibody was MP 17.88%(270/1 510), the second was IFVB of 11.32% (171/1510), the rest from high to low order were PIVs (1.59%), CP (0.33%),AdV (0.26%), RSV(0.26%), IFVA (0.26%), LP1 (0.20%), Qc (0.13%) respectively. Ninty-six cases were mixed infection,accounted for 6.36% (96/1510), the most common mixed infection was MP+IFVB, accounted for 4.97% (75/1510). There was no significant difference in positive rate between male and female (P>0.05). The age of children who were 1 to 14 years were susceptible, compared to that of 1 year old group, and the difference was statistically significant (P<0.05). The positive rate was highest in winter and lowest in summer, and the differences of positive rate between winter and summer and other seasons were statistically significant (P<0.05). Conclusion For children with acute respiratory tract infection in this region, MP, IFVB, and MP+IFVB are more easier to be infected. Therefore some clinical work should be done to prevent respiratory tract infection in children.

KEYWORDS: children with acute respiratory infection; pathogen; IgM antibody

参考文献：

[1] 王涛,郭坤,牛家峰,等.呼吸道病原体检测方法的研究进展[J].医学检验与临床,2010,21(4):95-96.

[2] 赵勤英,徐德顺,金文君.110 例儿童急性呼吸道感染病毒病原学调查[J].浙江预防医学,2011,23(6):76-78.

[3] HON KL,LEUNG AS,CHEUNG KL,et al.Typical or atypical pneu-monia and severe acute repiratory symptoms in PICU[J].Clin Respir J,2015,9(3):366-371.

[4] HUONG PIE T,HIEN PT,LAN NT,et al.First report on prevalence and risk factors of severe atypical pneumonia in Vietnamese children aged 1-15 years[J].BMC Public Health,2014,14(1):1-8.

[5] PIEDRA PA,MANSBACH JM,JEWELL AM,et al.Bordetella pertussis is an uncommon pathogen in children hospitalized with bronchiolitis during the winter season[J].Pediatr Infect Dis J,2015,34(6):566-570.

[6] POLVERINO E,TORRES A.Diagnostic strategies for healthcare-as-sociated pneumonia[J].Semin Respir Crit Care Med,2009,30(1):36-45

[7] 陈恒,江立千,李亚东,等.儿童急性呼吸道感染九种病原体的IgM抗体检测结果分析[J].检验医学与临床,2016,13(12):1665-1666.

[8] 郑辉,彭亮,卓广超.儿童呼吸道感染病原体IgM 抗体检测结果分析[J].中华医院感染学杂志,2015,25(1):235-237.

[9] 牛小斌,李永伟.小儿9项呼吸道感染病原体IgM 抗体检测结果分析.中华卫生检验杂志,2015,25(4):520-521.

[10] 罗丹,张晓阳,高向阳,等.普洱市儿童呼吸道感染病原体IgM 抗体九联检临床应用分析[J].国际检验医学杂志,2016,37(9):1205-1029.

[11] 俞晓春,胡荣盛,汪金云.958 例儿童急性呼吸道感染九种病原体IgM抗体检测结果分析[J].实用预防医学,2014,21(1):103-105.

[12] 王群,欧维琳,宋晓丹,等.喘息性疾病患儿血清九种呼吸道病原体IgM抗体检测研究[J].中国医药导报,2013,10(23):46-48.