儿童右肺中叶综合征30例病原学分析  

Etiologic Analysis of Right Lung Middle Lobe Syndrome in 30 Children

作　　者：童志杰[1] 黄建军[1] 余嘉璐[1] 曾强[1] 黄旭强[1] 邓爱群[1] 

机构地区：[1]广州市儿童医院呼吸科,广州510120

出　　处：《实用儿科临床杂志》2009年第4期291-292,共2页Journal of Applied Clinical Pediatrics

基　　金：广州市卫生局科研项目资助(2006-YB-73)

摘　　要：目的了解儿童右肺中叶综合征的主要病原类型。方法选择2006年8月-2008年5月收治右肺中叶综合征患儿30例。应用儿童型电子支气管镜,行温9 g/L盐水灌洗,无菌收集瓶收集肺泡灌洗液(BALF)。将BALF标本立即接种哥伦比亚绵羊血琼脂平板和万古霉素马血巧克力平板,放50 mL/L二氧化碳培养箱35℃培养18～24 h,将分离出的细菌进行鉴定至种。采用生物梅里埃公司的微生物鉴定仪VITEK2 compact鉴定,根据细菌革兰染色形态分别使用GN21341和GP21342鉴定卡,采用奥普托辛敏感试验及胆盐溶菌试验鉴定肺炎链球菌,鉴定采用V、X需求试验和卫星试验鉴定流感嗜血杆菌。采用荧光定量PCR方法检验肺炎支原体(MP)、腺病毒(ADV)、呼吸道合胞病毒,应用ELISA法测定其MP-IgM、CP-IgM和ADV-IgM。结果30例患儿中细菌阳性7例,分别为肺炎链球菌4例,肺炎克雷伯杆菌、大肠埃希杆菌、卡他莫拉菌各1例;MP3例;ADV3例;结核杆菌阳性1例。支气管异物2例(分别为花生和葵花籽)。结论儿童右肺中叶综合征的病因多种多样,有细菌、MP、ADV、结核菌以及异物等,细菌是最主要的病原体,其中肺炎链球菌最多见。Objective To analyze the etiologic types of children with right lung middle lobe syndrome. Methods Thirty children with right lung middle lobe syndrome from Aug. 2006 to May 2008 were selected. Broncho - clveolilavage fluids（BALF） of patients were collected by electron bronchosecope. The BALF were inoculated in agar plates with colombian sheep blood and chocolate plates with vancomycin horse blood ,and then cultured for 18 -24 hours with 50 mL/L CO2. The bacteria were isolated and identified until to species with special VITEK 2 compact assay. While the fluorescent quantitative - PCR was used to detect these organisms including mycoplasma pneumoniae （ MP）, adenovi- rus（ADV） and respiratory syncytial virus. Also the IgM of MP,chlamydia pneumonial and ADV were detected with ELISA. Results Seven of 30 cases were bacteria positive,of which 4 cases were streptococcus pneumoniae, 1 case was clebsiella pneumoniae, 1 case was case escherichia coli, 1 case were being catarrh moraxella bacterium. Three of 30 cases were MP,3 cases was being ADV and 1 case being tubercle bacillus, while 2 cases had foreign bodies （peanut and sunflower seed）. Conclusions The etiology of children＇s right lung middle lobe syndrome varied from bacteria, ADV, MP,tubercle bacillus and foreign body. Bacteria were the main causes, of which streptococcus pueumoniae is the most important etiological cause.

关 键 词：右肺中叶综合征 病原学 儿童 

分 类 号：R725.6[医药卫生—儿科]