痰培养及血清学联合检测肺炎衣原体性急性呼吸道感染

目的为了解成人急性呼吸道感染患者肺炎衣原体感染情况，为临床治疗提供参考。方法对９６例患者及４８例健康献血员同时行显微免疫荧光检测肺炎衣原体抗体，前者３７例同时行痰ＨＥＰ－２细胞培养分离肺炎衣原体。结果２６例患者（２９％）血清学ＩｇＧ≥１：５１２或ＩｇＭ≥１：３２提示急性肺炎衣原体性呼吸道感染，其中以急性支气管炎及支气管哮喘急性发作多见（分别为３５．８％及３０．０％）。对照组无一例出现急性感染血清学滴度。痰培养８例阳性（２１．３％，８／３７）经兔抗鼠免疫荧光染色确诊为肺炎衣原体。结论成人肺炎衣原体性急性呼吸道感染并非少见，应重视肺炎衣原体检测并给予特殊处理。     

老年慢性阻塞性肺疾病营养与脂类代谢的变化

目的 研究老年慢性阻塞性肺疾病（ＣＯＰＤ）急性发作期患者的营养状态和脂类代谢的变化和相互关系。方法 通过人体测量和内脏蛋白测定对５３例ＣＯＰＤ合并呼吸道感染的老年住院患者进行营养评价,应用气相色谱法测定血清游离脂肪酸,常规方法测定脂类与脂蛋白。结果 营养正常者（Ａ组）占３０．２％,营养不良者（Ｂ组）占６９．８％,两者患者血清甘油三酯,总游离脂肪酸均明显下降（Ｐ〈０．０５～〈０．０１）,其中以亚油酸     

老年心衰患者血清sIL—2R及T细胞亚群的变化

目的研究老年心衰（ＨＦ）患者血清中可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）及Ｔ淋巴细胞亚群（Ｔ－ＬＳ）的变化及临床意义。方法血清ｓＩＬ－２Ｒ测定采用酶联免疫吸附双抗体夹心法，Ｔ－ＬＳ采用抗体致敏的红细胞花环法。检测４０例老年ＨＦ及３０例正常组血清ｓＩＬ－２Ｒ及Ｔ－ＬＳ的变化。结果老年ＨＦ患者血清ｓＩＬ－２Ｒ水平与正常组比较显著增高（Ｐ＜０．０５，Ｐ＜０．０１）；Ｔ－ＬＳ在老年ＨＦ与正常组比较显著下降（Ｐ＜０．０５，Ｐ＜０．０１）。结论血清ｓＩＬ－２Ｒ水平及细胞免疫低下可影响老年ＨＦ的发病及预后     

204例呼吸道感染肺炎支原体调查

肺炎支原体（ＭＰ）是急性呼吸道感染的常见病原微生物,我们对１４４例成人和６０例儿童患者（包括患肺炎、支气管炎、上呼吸道感染、气管炎等）做了血清肺炎支原体抗体ＩｇＭ的检测,结果如下。１　对象和方法１．１　对象　１４４例成人患者为我院呼吸科住院病人,年龄在２１～６８岁之间,其中男９１例,女５３例;６０例儿童患者来自兰医一院门诊和我院儿科住院病人,年龄最小２岁,最大１２岁。其中男３４例,女２６例。患者采静脉血２～２．５ｍｌ,分离血清备用。１．２　方法　用ＥＬＩＳＡ－ＩｇＭ方法检测肺炎支原体特异ＩｇＭ抗…     

肺炎,支气管炎和急性上呼吸道感染患者肺炎衣原体感染的研究

１９９４年１～５月对北京地区１３４例急性呼吸系统疾病患者，以及与此配对的１３４例因其他疾病就诊的患者进行了前瞻性肺炎衣原体感染的研究。采用微量荧光试验检测肺炎衣原体ＩｇＧ抗体，其阳性率分别为９３％和８９％（Ｐ＞０．１）。两者患者抗体几何均数差异也未见有显著性（５５．９±４．２对４１．７±２．８，Ｐ＞０．１）。４例（４／３０）肺炎和６例（６／８１）支气管炎患者血清学诊断为近期肺炎衣原体感染。慢性支气管炎病史在肺炎衣原体感染者的伴随频率显著高于非肺炎衣原体感染者（Ｐ＜０．０５）。肺炎衣原体ＩｇＧ抗体几何滴度在具有慢性支气管炎患者中显著高于无该病史患者（Ｐ＜０．０５）。１３４例研究组患者咽后壁拭子肺炎衣原体分离全部为阴性。     

高血压性心脏病血清微量元素的测定及意义

目的研究老年高血压性心脏病（ＨＨＤ）血清中铜、锌、铁、钙、镁含量变化及意义。方法２４例老年ＨＨＤ患者血清中微量元素均采用原子吸收分光光度计测定。结果ＨＨＤ患者血清钙含量高于对照组（Ｐ＜０．０１），铜、锌、铁、镁的含量低于对照组（Ｐ＜０．０５，Ｐ＜０．０１）；ＨＨＤ患者血清铜含量明显低于高血压病组（Ｐ＜０．０１），钙、锌、铁、镁含量变化不显著（Ｐ＞０．０５）。结论低铜可促进老年ＨＨＤ的发生     

心肌钙蛋白和肌红蛋白在老年人甲亢性心脏病早期诊断中的意义

目的探讨血清心肌钙蛋白（ＣＴｎⅠ）和肌红蛋白（Ｍｂ）的含量在预防和早期诊断老年甲亢性心脏病中的价值。方法用放射免疫方法（ＲＩＡ）测定３７例老年前期及老年人甲状腺机能亢进（甲亢）患者（观察组）及３０例健康老年前期及老年人（对照组）血清中ＣＴｎⅠ、Ｍｂ的含量。结果甲亢组血清ＣＴｎⅠ、Ｍｂ含量显著高于对照组（均Ｐ＜０．０１）；甲亢缓解组血清ＣＴｎⅠ、Ｍｂ含量比甲亢组显著降低（均Ｐ＜０．０５）；对照组年龄与血清ＣＴｎⅠ、Ｍｂ含量之间无显著相关性（均为Ｐ＞０．０５）；１１例甲亢性心脏病患者血清ＣＴｎⅠ、Ｍｂ含量与对照组相比升高极显著（Ｐ＜０．００１）；观察组血清ＣＴｎⅠ、Ｍｂ含量与病程呈正相关（均为Ｐ＜０．０５）。结论ＣＴｎⅠ、Ｍｂ含量的测定对老年甲亢性心脏病的早期诊断和病情分析有重要临床价值     

胃粘膜萎缩与幽门螺杆菌感染在老年人反流性食管炎的作用

目的探讨胃粘膜萎缩与幽门螺杆菌（ＨＰ）感染在老年人反流性食管炎（ＲＥ）的作用。方法用内镜、组织学检查，血清胃蛋白酶原Ⅰ、Ⅱ（ＰＧⅠ、Ⅱ）测定、快速尿素酶及美蓝染色对４９例老年反流性食管炎患者进行胃粘膜萎缩及ＨＰ感染测定。结果老年ＲＥ患者重度胃粘膜萎缩百分率、ＨＰ感染率显著低于对照组（Ｐ值分别＜０．００５及０．０１）。ＲＥ组ＰＧⅠ、Ⅱ比率显著高于对照组（Ｐ＜０．００１）。结论提示老年ＲＥ患者ＨＰ感染少，胃粘膜萎缩轻、胃酸分泌相对正常，该结果为老年ＲＥ正确治疗提供了基础     

慢性乙肝病毒感染与抗磷脂抗体的关系

探讨慢性乙肝病毒（ＨＢＶ）感染与抗磷脂抗体（ＡＰＡ）水平的相关性；采用ＥＬＩＳＡ方法，检测慢性乙型肝炎及乙肝乙肝硬化患者血清中ＡＰＡ的水平；与对照组相比，患者血清中ＡＰＡ均有显著升高（Ｐ〈０．０５），且两组患者间亦有显著差异（Ｐ〈０．０５）；慢性ＨＢＶ感染ＡＰＡ相关且ＡＰ随病程的进展而升高。     

冬季成人急性呼吸道疾病住院患者肺炎支原体抗体检测及分析

目的 了解冬季住院既往体健和有慢性肺部基础疾病患者急性呼吸道疾病的肺炎支原体感染情况.方法 选择2008年12月中旬至2009年3月北京军区总医院呼吸内科收治的急性呼吸道疾病患者73例,应用被动明胶颗粒凝集试验检测患者血清中肺炎支原体抗体滴度,以抗体滴度≥1:160判为阳性.结果 既往体健组的肺炎支原体感染率为48.3%,慢性肺部基础疾病组肺炎支原体感染率为22.7%,两组之间感染率差异有统计学意义(P<0.05).既往体健组的年龄明显小于有基础性肺部疾病组(P<0.05),而且MP的感染率与性别无关(P>0.05).结论 既往体健的急性呼吸道感染青壮年患者肺炎支原体感染率明显高于有慢性肺部基础疾病的患者.     

梧州地区住院患者呼吸道病毒及非典型病原体的抗体检测分析

目的探讨梧州地区急性呼吸道感染住院患者呼吸道病毒和非典型病原体感染的情况。方法2014年7月至2015年6月在广西梧州市工人医院住院的急性呼吸道感染患者血清,应用间接免疫荧光法(IFA)定性检测九种呼吸道感染病毒及非典型病原体Ig M抗体,分别是流感病毒A/B、副流感病毒、呼吸道合胞病毒、腺病毒、嗜肺军团菌、肺炎支原体、肺炎衣原体、Q热立克次体。结果呼吸道病原体血清抗体总阳性率为20.97%,其中肺炎支原体阳性率最高,其次B型流感病毒、副流感病,分别是15.80%、2.43%、1.97%。一年中,秋季血清阳性率最高(50.00%),其次冬季(20.13%),与春季、夏季比较差异有统计学意义(P0.05)。不同年龄段中,青年血清阳性率最高,老年组血清阳性率最低。18例B型流感病毒血清阳性中,合并支原体血清阳性9例(9/18=50.00%),12例副流感病毒中,合并支原体7例(7/12=58.33%)。结论 :梧州地区急性呼吸道感染住院患者吸道病毒和非典型呼吸道病原体感染率较高,并以肺炎支原体最高,其次B型流感病毒、副流感病毒;且青年组较老年组发病率高;以秋、冬季节高发;流感病毒、副流感病毒血清阳性混合感染肺炎支原体发生率较高。     

Pneumonia--a clinical or radiographic diagnosis? Etiology and clinical features of lower respiratory tract infection in adults in general practice.

Etiology and clinical manifestations have been studied in 153 adult patients with lower respiratory tract infection, and the results are presented according to clinical and radiographic diagnosis. Laboratory investigations revealed that bacterial infection, mycoplasma and chlamydia included, occurred as often in 22 patients whose clinical diagnoses of pneumonia were not evident radiographically, as in 20 patients with radiographic pneumonia. In the latter group significantly higher values of erythrocyte sedimentation rate and C-reactive protein were demonstrated. The most common pathogen was influenzavirus A, followed by respiratory syncytial virus, Streptococcus pneumoniae, and Mycoplasma pneumoniae. Chlamydia pneumoniae infection was found in 3 patients with radiographic pneumonia. The study supports the traditional view that patients with a positive chest radiograph as a rule present more serious manifestations of lower respiratory tract pathology than patients with a normal radiograph. However, as only 1/9 patients with pneumococcal infection and 2/7 with mycoplasmal infection had radiographic evidence of pneumonia, radiography alone did not seem to offer sufficient information for selecting patients for antibacterial therapy.     

老年获得性肺炎支原体感染的检测与分析

目的 对老年肺炎支原体感染的检测进行分析。方法 对96例社区获得性老年肺炎支原体感染患者应用间接免疫荧光法检测肺炎支原体IgM抗体,同时检测患者血常规、血沉、C反应蛋白、降钙素原。结果 老年肺炎支原体感染率为15.4%,年龄、性别之间无统计学差异。呼吸道感染占89.6%,非呼吸道疾病占9.4%;混合感染率21.9%;原有基础疾病者占20.8%。结论 肺炎支原体是引起老年人呼吸系统感染及呼吸系统外并发症的主要原因之一,应引起足够重视。     

呼吸系统疾患新生犊牛支原体感染监测

目的检测呼吸系统疾患新生牛犊支原体感染情况,研究犊牛呼吸系统支原体感染与母牛生殖道支原体感染的关系。方法利用培养基法、显微镜检查法、套式PCR等,对出生后有明显呼吸系统疾病症状的20头犊牛气管及肺内支原体感染情况进行检测,并以5头健康犊牛做作对照。结果 20头患病犊牛呼吸道内支原体检出率为70%,50%存在呼吸道黏膜细胞胞内感染;分离的支原体经鉴定为牛支原体、精氨酸支原体和人型支原体。结论呼吸系统疾患新生牛犊感染的支原体种类,与文献报道的从母体泌尿生殖道分离到的部分支原体相似,新生犊牛呼吸系统支原体感染与母牛泌尿生殖道支原体感染有密切关系。     

儿童肺炎支原体肺炎治疗进展

肺炎支原体肺炎是学龄儿童常见的一种肺炎,婴幼儿也可发生.虽然肺炎支原体感染有一定的自限性,但近年来难治性肺炎支原体肺炎的出现,使肺炎支原体肺炎治疗面临巨大挑战,如何合理治疗肺炎支原体肺炎,对儿童健康的恢复具有重要意义.肺炎支原体肺炎的治疗包括有效抗菌药物、免疫调节及支气管镜等,应根据患儿不同的病情进展情况采取相应的治疗方案.     

Mycoplasma pneumoniae infection in hospitalized children with acute pneumonia under the Mycoplasma epidemic

Since October 2000, Mycoplasma pneumonia has been a recurring epidemic in Japan. To become clear the importance of Mycoplasma pneumoniae infection in children, we investigated cross-sectionally M. pneumoniae infection by serology in the hospitalized children age under seven years with acute pneumonia retrospectively reviewing pediatric patients of the four studies about lower respiratory tract infection which we had been treated during 2001 to 2003. Firstly, we found M. pneumoniae infection in 75 patients (33.8%) among a total of 222 patients with asthma exacerbation and acute pneumonia in 2001. Second, we had evaluated a total of 46 hospitalized children with acute pneumonia for M. pneumoniae infection in November 2002 and 18 patients (39.1%) were found. Thirdly, we found M. pneumoniae infection in 8 patients (34.8%) among 23 patients with respiratory syncitial virus and acute pneumonia age under two years during October 2002 to April 2003. Fourthly, we found M. pneumoniae infection in 19 patients (35.8%) among 53 patients with asthma exacerbation and acute pneumonia during January from June in 2003. Even only among the patients age under two years M. pneumoniae infection was found to be 24.3% (16/70), 27.8% (5/8), 34.8% (8/23) and 33.3% (7/21), respectively. These findings demonstrate that M. pneumoniae is common pathogen of acute pneumonia even in infants and young children under Mycoplasma epidemic. Not only typical bacteria and but also M. pneumoniae should be considered as important pathogens in the treatment of acute pneumonia in infants and young children under Mycoplasma epidemic.     

成人肺炎支原体肺炎并发症的预防和处理

成人肺炎支原体(MP)肺炎是由MP感染引起的肺炎,临床表现以发热、咳嗽、乏力、肺部体征不明显为特征。近年来MP肺炎发病率呈不断上升趋势,儿童好发,但成人患MP肺炎逐渐增多。MP感染除了引起肺部感染外,可在肺内引起急性呼吸窘迫综合征和脓胸,还可并发肺外多系统损害,病变可累及神经、血液、心血管、消化、运动等多个系统,严重时可危及生命,受到越来越多的关注。本文就成人MP肺炎的并发症作一综述,以提高对其诊治水平。     

不同时期老年社区获得性肺炎患者不典型病原检测结果分析

目的 调查3个时期老年社区获得性肺炎(CAP)住院患者病毒、支原体、衣原体及军团菌感染状况,为临床流行病学研究提供参考. 方法 选取2001年10月至2004年6月[称为围严重急性呼吸综合征(SARS)期]、2005年7月至2007年10月及2008年1月至2010年12月(称为围甲流期)于河北联合大学附属医院住院的492例老年患者作为研究对象,于入院当天及入院后7～10d行血清支原体、衣原体、军团菌IgM抗体及7种常见病毒IgM抗体检查,对3个期间的资料进行分析. 结果 492例患者支原体IgM抗体阳性80人次(16.26％)、衣原体IgM抗体阳性46人次(9.35％)、军团菌IgM抗体阳性25人次(5.08％)、病毒IgM抗体阳性118人次(23.99％).“围SARS期”不典型病原体总检出率及军团菌、合胞病毒、巨细胞病毒、单纯疱疹病毒及风疹病毒检出率明显高于其他2个时期.不典型病原体抗体在起病20d内的检出率较高. 结论 不典型病原体仍为老年CAP的重要致病原,其中以支原体感染最为常见.前后对比围SARS期间病毒感染更为普遍.老年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 d内多数不典型病原体感染患者IgM抗体可检出阳性.     

Clinical presentation, diagnosis and treatment of Mycoplasma pneumoniae pneumonia

Mycoplasma pneumoniae is a common respiratory pathogen in community acquired pneumonia. In severe cases extrapulmonary manifestations of the disease may be prominent. Proof of infection is found, though usually delayed, through serologic methods. A calculated therapy of community acquired pneumonia, especially in younger patients with interstitial infiltrates, should therefore include effective treatment for Mycoplasma pneumoniae. Macrolide antibiotics are the most commonly used antibiotics in the treatment of mycoplasma infection, alternatives include ketolides, quinolones and tetracyclines.     

Prevalence of Mycoplasma and Chlamydia pneumonia in severe community-acquired pneumonia among hospitalized children in Thailand

Pneumonia is the leading cause of pediatric morbidity and mortality worldwide, and Mycoplasma pneumoniae and Chlamydia pneumoniae are the two most common atypical pathogens. This study was designed to determine the prevalence and clinical impact of mycoplasma and chlamydia pneumonia in children hospitalized with severe pneumonia. Children 1 month-15 years old with a diagnosis of severe pneumonia (WHO criteria) were recruited between March 2005 and March 2006. Serologic studies were performed for anti-M. pneumoniae and anti-C. pneumoniae IgG/M on admission and 2-4 weeks afterward using ELISA. Of 52 patients, 13 (25%) were positive for Mycoplasma, 8 (15%) were positive for Chlamydia, 4 (7.6%) were positive for a mixed infection and 27 (52%) were negative. The subjects' mean age was 23.8+/-4.1 months. The mean of initial oxygen saturation on admission was 87.5+/-1.2%. Fever and prolonged cough were the leading symptoms. The mean of hospitalization was 18.8+/-2.6 days, chlamydia pneumonia had the longest duration, 30+/-10.2 days and 13/52 (25%) study subjects developed respiratory failure. Only 10% were treated with adequate antibiotic prior to serologic results. There was one mortality (1/52, 2%). Our study suggests that mycoplasma and chlamydia infections are commonly found among children hospitalized with severe pneumonia. Coverage with an appropriate antibiotic should be considered to hasten recovery.