天津医药

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住院社区获得性肺炎患者不典型病原感染病原学研究

刘梅   

  1. 天津科技信息研究所
  • 收稿日期:2011-10-11 修回日期:2012-03-01 出版日期:2012-08-15 发布日期:2012-08-15
  • 通讯作者: 刘梅

Pathogenic study of atypical pathogens infection in hospitalized patients with community acquired pneumonia

  • Received:2011-10-11 Revised:2012-03-01 Published:2012-08-15 Online:2012-08-15

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摘要： 摘要：目的 分析社区获得性肺炎(community acquired pneumonia CAP)住院患者病毒、支原体、衣原体及军团菌感染状况，为CAP住院患者的初始经验性治疗提供相关参考。方法 选取2001年10月~2004年6月及2008年1月~2010年12月期间于华北煤炭医学院附属医院住院的1079例CAP患者作为研究对象，于入院当天及入院后7-10天留取血清行支原体、衣原体、军团菌IgM抗体及病毒IgM抗体(包括EB病毒、腺病毒、合胞病毒、巨细胞病毒、单纯疱疹病毒、柯萨奇病毒、风疹病毒)检查。同时对不同时间资料进行分析。结果 1079例患者支原体IgM抗体阳性165人次(15.29%)、衣原体IgM抗体阳性99人次(9.18%)、军团菌IgM抗体阳性58人次(5.38%)、病毒IgM抗体阳性358人次(33.18%)。前后对比军团菌、合胞病毒、巨细胞病毒、单纯疱疹病毒、风疹病毒及EB病毒检出率明显下降。柯萨奇病毒、EB病毒和合胞病毒抗体在起病10~20天内检测的检出率要明显高于9天前及20天后的检出率。结论 不典型病原体仍为CAP的重要致病原，其中以支原体感染最为常见。前后对比CAP患者不典型病原体感染率无明显上升，部分有下降趋势。在起病20天内多数不典型病原体感染患者IgM抗体可检出阳性。

关键词: 社区获得性肺炎, 病原, 支原体, 衣原体, 军团菌, 病毒

Abstract: Abstract Objective: to analyse virus, mycoplasma, chlamydia and legionella infection status of community acquired pneumonia (CAP) in hospitalized patients and to provide reference resources for empirical treatment of CAP. Methods: 1079 with CAP who were treated in the respiratory medicine department of Hebei unitedu niversity affiliated hospital during October 2001 to June 2004 and January 2008 to December 2010 were objects of study. All patients’ serums were collected for IgM antibody detection (including chlamydia, mycoplasma, Legionella and virus such as EB virus, adenovirus, respiratory syncytial virus, cytomegalovirus, herpes simplex virus, Coxsackie virus, rubella virus) in the day be hospitalized and 7-10 days later at the same time data in different period were analysed. Results：In 1079 patients, positive results include 165(15.29%) chlamydia, 99 (9.18%) mycoplasma, 58(5.38%) legionella and 358(33.18%) virus. In comparison, the detection rates of legionella, syncytial virus, cytomegalovirus, herpes simplex virus, rubella virus and EB virus were decreased obviously. Antibodie’s detection rate of Coxsackie, EB and syncytial virus in the onset of 10~20 days was higher than that in 9 days ago and 20 days after. Conclusion：Atypical pathogens are important pathogenic in CAP, mycoplasma infection is one of the most common reasons. In comparison, infection rate of atypical pathogens in patients with CAP was not significantly increased and in part has a downward trend. In the onset of 20 days, most positive result of IgM antibody can be found in patient with.atypical pathogens infection.

Key words: CAP, pathogeny, chlamydia, mycoplasma, legionella, virus