儿童肺炎衣原体肺炎病原学检测及其临床应用  

Etiological diagnosis of chlamydia pneumoniae pneumonia

作　　者：鲁继荣[1] 张一宁[1] 王玥[1] 刘桂英[1] 傅文永[1] 王敏[2] 

机构地区：[1]吉林大学第一医院儿科 [2]吉林省妇幼保健院

出　　处：《中华儿科杂志》2001年第10期605-607,共3页Chinese Journal of Pediatrics

摘　　要：目的　了解儿童肺炎衣原体 (C pn)肺炎的发病情况 ,探讨套式聚合酶链反应 (nPCR)及微量免疫荧光 (MIF)检测肺炎衣原体肺炎的临床意义。方法　联合应用nPCR及MIF检测 30 0例肺炎患儿及 130例健康儿童 ,结果进行统计学分析 ,并随机选取 2例nPCR阳性标本 ,进行DNA测序。结果　检测 30 0例肺炎中 ,nPCR阳性且MIF符合急性感染标准者 30例 ,即确诊为肺炎衣原体肺炎 ,占肺炎总数的 10 0 %。nPCR阳性者 42例占 14 0 % ,MIF符合急性感染标准者 31例 ,占 10 3% ,在年龄分布上 ,12 0例≤ 3岁者有 16例nPCR阳性 ,阳性率 13 3% ,8例MIF符合急性感染标准 ,阳性率 6 7% ;180例 >3岁患儿中 2 6例nPCR阳性 ,阳性率 14 4% ,2 3例MIF符合急性感染标准 ,阳性率 12 8%。130例健康对照组儿童中 ,nPCR均呈阴性 ,虽有 2 4例MIFIgG≥ 1∶16 (IgG滴度分别为 1∶16～ 1∶12 8) ,但无一例符合急性感染标准。 2例nPCR阳性标本nPCR产物之DNA序列与C pn标准株 (CWL 2 9)完全一致。结论　肺炎衣原体是儿童肺炎重要的病原 ,nPCR诊断肺炎衣原体感染快速、简便、敏感、特异性高 。Objective Chlamydia pneumoniae (Cp), a newly descried chlamydia species in late 1980′s, is a common etiological agent which can cause not only upper respiratory tract infections, asymptomatic pneumonia, and asthma, but also coronary heart disease, sarcoidosis, etc Among the diseases caused by Cp, 50% is pneumonia, in which symptoms appear long after the infection and the recovery may still take a long time The purpose of the present study was to assess the morbidity of Cp pneumonia, evaluate two methods (nested polymerase chain reaction i e , nPCR and microimmunofluorescence i e , MIF) in detecting Cp infection Methods A prospective study for Cp infection was conducted in 300 children with pneumonia (120 were under 3 years of age, while 180 were over 3 years of age) and 130 healthy children (55 were under 3 years while 75 were over 3 years of age) from October, 1998 to March, 2000 Sputum and throat swab specimens were taken and Cp DNA was detected with nPCR At the same time, serum samples were taken and immunoglobulin G and M (IgG and IgM) classes of antibodies to Cp were studied by MIF test The direct sequencing of products of 2 samples positive on nPCR was analyzed Results Of the 300 children with pneumonia, 30 cases (10%) were positive by nPCR ,at the same time they met the criteria for acute infection. They were diagnosed as Cp pneumonia; 42 cases were positive on nPCR; 31 cases met the criteria for acute infection with Cp Of the children under 3 years of age (including 3 years old), 16 (13 3%) were positive for Cp by nPCR in sputum and/or swab specimens and 8 children (6 7%) met the MIF criteria for acute infection Of the children beyord 3 years of age, 23 children (12 8%) met the MIF criteria for acute infection and 26 Children (14 4%) were positive for Cp by nPCR in sputum and/or swab specimens Specimens from 130 healthy children were all negative for Cp by nPCR while 24 children′s (18 4%) IgG titer increased from 1:16 to 1:128, but no one met the criteria of acute inf

关 键 词：聚合酶链反应 荧光免疫测定 衣原体 肺炎 感染 儿童 

分 类 号：R725.6[医药卫生—儿科]