摘要
目的 探讨新生儿感染性肺炎的病因学、临床特征和免疫功能的变化。方法 采用酶联免疫吸附试验 (ELISA)检测 111例肺炎患儿血中 8型常见病毒及肺炎支原体特异性IgM ,速率散射比浊法测定C 反应蛋白 (CRP)和免疫球蛋白 (IgG及其亚类、IgA、IgM ) ,链菌素亲生物素 过氧化酶连接法 (SP)检测T淋巴细胞亚群 ,并对临床表现和其他实验室检查结果进行分析。选取同期非肺炎新生儿 30例作为对照。结果 ⑴肺炎组 111例患儿血清中 ,特异性IgM阳性 4 0例 (36 0 % ) ;对照组 30例的血清中 ,特异性IgM检测均阴性。病毒及支原体感染 2 3例 (2 0 7% ) ,细菌感染 4 5例(40 5 % ) ,病毒及支原体与细菌混合感染 17例 (15 3% ) ,其他不明病原感染 2 6例 (2 3 4 % )。⑵新生儿感染性肺炎最常见的症状和体征是气促、发绀 ,其次是咳嗽、呛奶、肺部音、三凹征 ;X线检查以纹理模糊、纹理增多增粗、斑片影多见。⑶免疫学检查中 ,肺炎组CD3 、CD4细胞数小于对照组 (P <0 0 5 ) ,IgA、IgM含量大于对照组 (P <0 0 5 )。病毒及支原体感染组IgA含量大于其他不明病原感染组和对照组 (P <0 0 5 ) ;细菌感染组IgM含量大于对照组 (P <0 0 5 )。CD8、CD4/CD8、IgG、IgG1 4在肺炎组与对照组、各感染组两两间。
Objective To explore etiology,clinical manifestation and immunological changes of infectious pneumonia of neonates in Chengdu area.Methods Serum specimens were collected from 111 infants with infectious pneumonia. Eight viral and mycoplasmal specific serum IgM antibodies were detected by enzyme linked immunosorbent assay(ELISA);C reactive protein(CRP),total IgG and its subclasses,IgA and IgM were determined by rate scattered nephelometry; T lymphocyte subpopulations were detected by biotin-streptavidin-peroxidase method,and cliniacal and other laboratory data were analyzed.Results ⑴ Etiological agents: specific serum IgM antibodies were positive in 40 of 111 cases(36.0%)with pneumonias.All the 30 control infants were negetive for the specific serum IgM antibodies.Among 111 infants with infectious pneumonia,20.7% had single viral or mycoplasmal infection,40.5% had bacterial infection,15.3% had viral and mycoplasmal infection with bacterial infection; 23.4% had infection with unknown agents.⑵The most common clinical manifestations were tachypnea and cyanosis.The next were cough, milk choking,rales,retractions of the supraclavicular,intercostal and subcostal areas.Roentgenographic examination commonly revealed vague opacities,increased density and patchy infiltration.⑶ Immune status:① CD_3,CD_4 cell counts of infants with pneumonias were lower than those of the controls while their serum IgA,IgM concentrations were higher than those of the control.② The CD_3 and CD_4 cell counts of the group with bacterial infection were lower than those of the control group.③ The serum IgAconcentration of the group with viral and mycoplasmal infection was higher than those of the control group and the group with unknown infection.④ The serum IgM concentration of the group with bacterial infection was higher than those of the control group.⑤ There were no significant differences in CD_8 cell counts,CD_4/CD_8,concentration of serum IgG and IgG_ 1-4 between pneumonia group and the control group,and among various infectious groups and the control.Conclusion Pathogens of neonatal infectious pneumonia in Chengdu area included single viral or mycoplasmic infection or bacterial infection,viral and mycoplasmal infection with bacterial infection,and unknown infection. Immunological changes of newborn infants suffered from infectious pneumonia included declined CD_3 and CD_4 cell counts, particularly in bacterial infection.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2003年第12期884-888,共5页
Chinese Journal of Pediatrics
基金
四川省卫生厅科研基金资助项目 (0 0 0 0 92 )
关键词
新生儿
感染性肺炎
免疫功能
病因学
Infant,newborn
Pneumonia,viral
Pneumonia, mycoplasma
T-lymphocyte subsets
Immunoglobulin G
