成人非典型社区获得性肺炎患者病原体感染情况分析  

Pathogen infection of adult community-acquired atypical pneumonia

作　　者：申春梅 冷蓓铮 刘亚隽 张慧 周聪 徐茂锁 贺乐奇 SHEN Chunmei;LEN Beizheng;LIU Yajun;ZHANG Hui;ZHOU Cong;XU Maosuo;HE Leqi(Department of Clinical Laboratory,the Fifth People's Hospital of Shanghai,Fudan University,Shanghai 200240,China;Department 2 of Infection Disease,the Fifth People's Hospital of Shanghai,Fudan University,Shanghai 200240,China)

机构地区：[1]复旦大学附属上海市第五人民医院检验科,上海200240 [2]复旦大学附属上海市第五人民医院感染二科,上海200240

出　　处：《检验医学》2020年第1期29-32,共4页Laboratory Medicine

基　　金：上海市闵行区自然科学基金资助项目（2017MHZ85）

摘　　要：目的分析肺炎支原体(MP)等经典微生物引起的非典型肺炎患者的实验室检查结果,为临床诊治提供参考。方法采用实时荧光定量聚合酶链反应(qPCR)检测188例成人社区获得性肺炎患者急性期咽拭子和/或痰液样本中的MP、肺炎衣原体和嗜肺军团菌,分析每位患者的临床资料、实验室指标、影像学检查结果。结果MP核酸检测阳性41例(21.8%),肺炎衣原体核酸检测阳性1例(0.5%),未检出嗜肺军团菌;细菌培养阳性23例(12.23%)。MP阳性患者年龄较阴性患者小,较少伴有基础疾病,肺部以单侧受累为主,其他临床症状和实验室相关指标差异均无统计学意义。秋季、冬季MP阳性率明显高于春季、夏季(P<0.05)。结论MP是成人社区获得性肺炎的主要病原体,qPCR对MP急性感染的早期诊断具有明显的优势。Objective To analyze the laboratory findings of adult community-acquired atypical pneumonia caused by classic microorganisms,like Mycoplasma pneumoniae(MP),and to provide a reference for clinical diagnosis and treatment.Methods A total of 188 adults with community-acquired pneumonia were enrolled.Real-time fluorescence quantitative polymerase chain reaction(qPCR)was used to determine MP,Chlamydia pneumoniae and Legionella pneumophila in sputum and/or orotharyngeal(OP)swabs.The clinical characteristics,laboratory findings and radiological data were analyzed.Results The positive rate of MP was 21.8%(41 cases).Only 1 case was positive for Chlamydia pneumoniae,and all samples were negative to Legionella pneumophila.There were 23 positive cases of bacterial culturing(12.23%).Compared with MP negative group,MP positive group was younger,with fewer basic diseases,and pulmonary involvement was mainly unilateral.There was no statistical significance in the other clinical symptoms and laboratory findings.The positive rate of MP in autumn and winter was higher than those in spring and summer(P<0.05).Conclusions MP is the main pathogen of adult communityacquired atypical pneumonia.The qPCR has advantages in the early diagnosis of acute MP infection.

关 键 词：社区获得性肺炎 肺炎支原体 实时荧光定量聚合酶链反应 

分 类 号：R563.1[医药卫生—呼吸系统]