婴幼儿病毒性肺炎的病毒病原学及临床特点  

Etiology,clinical and immunological studies on infant viral pneumonia.

作　　者：郭渠莲[1] 刘文君[1] 曾国庆[1] 陈书琴[1] 王开正[2] 邓正华[2] 蔡美珠[2] 曾瑜[2] 

机构地区：[1]泸州医学院附属医院儿科,四川泸州646000 [2]泸州医学院附属医院检验科,四川泸州646000

出　　处：《中国儿童保健杂志》2006年第4期333-335,共3页Chinese Journal of Child Health Care

基　　金：四川泸州市科技局重点项目(2001341)

摘　　要：[目的]探讨本地区引起小儿病毒性肺炎的病原学概况及其相应临床表现,为临床诊治提供依据.[方法]应用ELISA法检测325例婴幼儿肺炎患儿急性期血清中五种常见病毒（RSV、IFV、CMV、ADV、PIV）血清特异性IgM;用速率散射比浊法测定C-反应蛋白（CRP）和免疫球蛋白.用碱性磷酸酶标记链霉卵白素（S-A/AP）法检测人外周血T淋巴细胞亚群.[结果]325例婴幼儿肺炎中共检出病毒感染157例,病毒感染率48.3%,单一病毒感染113例（72.0%）,其中合胞病毒（RSV）32株（20.4%）,流感病毒（IFV）27株（17.2%）,腺病毒（ADV）22株（14.0%）,副流感病毒（PIV）17株（10.8%）,巨细胞病毒（CMV）15株（9.6%）;混和病毒感染共44例（28.0%）,以IFV＋PIV 15例（9.6%）多见.RSV肺炎患儿喘息重,缺氧征明显;ADV肺炎患儿以高热和中毒表现为主;IFV和PIV肺炎患儿主要表现为咳嗽重、喘息轻;CMV肺炎患儿除一般症状外,常伴肝功能异常.1～3个月、～12月、～3岁三个年龄组病毒性肺炎患儿血清lgG、lgA、lgM与对照组比较,差异均无显著性（P＞0.05）;而T细胞亚群与对照组比较,CD3、CD4、CD4/CD8均降低、CD8升高,差异均有显著性（P＜0.05）.[结论]病毒感染是婴幼儿肺炎的主要病原,各类病毒性肺炎各有其临床特点,细胞免疫功能紊乱在小儿病毒性肺炎发病机制中起重要作用.[Objective] To explore etiology, clinical manifestation and immunological changes of infant community acquired viral pneumonia. [Methods] Methods Five common viral specific serum IgM antibodies were detected by enzyme-linked immunosorbent assay （EI.ISA） from 325 cases of infant pneumonia blood. C-reactive protein（GRP）, IgG, IgA, IgM were detected by rate scattered nephelometry. T lymphocyte subpopulation was detected by Streptavidin-alkaline phosphatase （S-A/AP）. The compared group was local healthy infant in the same time and same age-stage. [Results] 157 viral cases were detected from 325 cases of infant pneumonia, the viral infection rate was 48.3 %. There were 113 single viral infection cases, among them RSV 32 cases （20.4 % ）, IFV 27 cases （ 17.20% ）, ADV 22 cases （ 14.0 %）, PIV 17cases （ 10.8 % ）, CMV 15 eases （9.6%）. There were 44 mixed viral infection eases,among them IFV＋ PIV： 15 eases（9.6 % ） ,and they were the first. RSV pneumonia infants were seriously asthma and anoxia,ADV pneumonia infants were serious hyperpyrexia, poisoning symptom,IFV and PIV pneumonia infant coughed seriously, but asthma was slight,CMV pneumonia infant often accompany abnormality liver function besides common pneumonia symptom. There were not significant differences between three age-stage group（ 1 - 3months, - 12months,- 36months） of viral pneumonia and compared group （ all P 〉0. 05）. There was significant deference in T lymphocyte subpopulation between viral pneumonia group and compared group （all P〈0. 05） ,concretely display CDs ,CDt ,CD,/CDs all decline,but CD8 rose up in the viral group. [Conclusions] Viral infection was the main pathogenesis of infant pneumonia. Each kind of viral pneumonia had its own clinical characteristics. Cellular immunity disturbance was the main mechanism of infant viral pneumonia＇s invasion.

关 键 词：婴幼儿 肺炎 病毒病原学 T细胞亚群 免疫球蛋白 

分 类 号：R722[医药卫生—儿科]