中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2011年
9期
820-823
,共4页
崔京涛%吴叶丽%李倩%窦亚玲%倪安平
崔京濤%吳葉麗%李倩%竇亞玲%倪安平
최경도%오협려%리천%두아령%예안평
肺炎,支原体%支原体,肺炎%抗体,细菌%血清流行病学研究%抗菌药%凝集试验
肺炎,支原體%支原體,肺炎%抗體,細菌%血清流行病學研究%抗菌藥%凝集試驗
폐염,지원체%지원체,폐염%항체,세균%혈청류행병학연구%항균약%응집시험
Pneumonia,mycoplasma%Mycoplasma pneumoniae%Antibodies,bacterial%Seroepidemiologic studies%Anti-bacterial agents%Agglutination tests
目的 分析肺炎支原体感染血清流行病学资料及随访评价部分阳性者抗菌药物疗效。方法用Serodia-Mycoll颗粒凝集试剂盒检测3 134份临床疑似肺炎支原体感染者的血清抗体，判断肺炎支原体感染者并分析其流行病学资料，包括抗体总阳性率、男女阳性率差异、季节阳性率差异、年龄组阳性率差异及不同标本来源阳性率的差异等。随访评价部分阳性者抗菌药物疗效，统计使用抗菌药物的天数、不同抗菌药物使用情况，以及治愈、好转及疗效较差的比例等。结果 收集3 134份临床疑似肺炎支原体感染者的血清标本，其中350份(11.2％)肺炎支原体抗体阳性。女性患者阳性率为12.3％( 198/1 604)，高于9.9％( 152/1 530)男性患者阳性率，差异有统计学意义(X2=4.58，P＜0.05)。肺炎支原体抗体阳性率最高季节在第4季度（10～12月），为13.2％ (95/719)；肺炎支原体抗体阳性率最高年龄组位于5～9岁，为32.8％ (45/137)。儿科门诊及儿科病房为肺炎支原体抗体阳性率最高的标本来源，分别为27.9％ (56/201)和26.5％(60/226)。社区获得性肺炎患者肺炎支原体抗体阳性率为28％ (7/25)，高于其他疾病患者组。随访91例阳性患者中，自出现临床症状至就诊/抗体检测的时间为5～120 d,平均24.2d。71例(78.0％)患者使用大环内酯类抗菌药物治疗，4例(4.4％)使用喹诺酮类抗菌药物，4例(4.4％)使用头孢类抗菌药物治疗，其余12例(13.2％)使用其他抗菌药物或对症处理。上述抗菌药物治疗时间3～21 d，平均8.2d。疗效随访结果是治愈35例(38.5％),好转50例(54.9％)，6例(6.6％)疗效较差。结论肺炎支原体抗体阳性率女性高于男性，第四季度和学龄期儿童分别是肺炎支原体感染的高峰季节和高峰年龄组。儿科门诊及病房为肺炎支原体抗体阳性率最高的标本来源。临床医生能够根据肺炎支原体实验室检测结果选择一线抗菌药物并获得良好的疗效。
目的 分析肺炎支原體感染血清流行病學資料及隨訪評價部分暘性者抗菌藥物療效。方法用Serodia-Mycoll顆粒凝集試劑盒檢測3 134份臨床疑似肺炎支原體感染者的血清抗體，判斷肺炎支原體感染者併分析其流行病學資料，包括抗體總暘性率、男女暘性率差異、季節暘性率差異、年齡組暘性率差異及不同標本來源暘性率的差異等。隨訪評價部分暘性者抗菌藥物療效，統計使用抗菌藥物的天數、不同抗菌藥物使用情況，以及治愈、好轉及療效較差的比例等。結果 收集3 134份臨床疑似肺炎支原體感染者的血清標本，其中350份(11.2％)肺炎支原體抗體暘性。女性患者暘性率為12.3％( 198/1 604)，高于9.9％( 152/1 530)男性患者暘性率，差異有統計學意義(X2=4.58，P＜0.05)。肺炎支原體抗體暘性率最高季節在第4季度（10～12月），為13.2％ (95/719)；肺炎支原體抗體暘性率最高年齡組位于5～9歲，為32.8％ (45/137)。兒科門診及兒科病房為肺炎支原體抗體暘性率最高的標本來源，分彆為27.9％ (56/201)和26.5％(60/226)。社區穫得性肺炎患者肺炎支原體抗體暘性率為28％ (7/25)，高于其他疾病患者組。隨訪91例暘性患者中，自齣現臨床癥狀至就診/抗體檢測的時間為5～120 d,平均24.2d。71例(78.0％)患者使用大環內酯類抗菌藥物治療，4例(4.4％)使用喹諾酮類抗菌藥物，4例(4.4％)使用頭孢類抗菌藥物治療，其餘12例(13.2％)使用其他抗菌藥物或對癥處理。上述抗菌藥物治療時間3～21 d，平均8.2d。療效隨訪結果是治愈35例(38.5％),好轉50例(54.9％)，6例(6.6％)療效較差。結論肺炎支原體抗體暘性率女性高于男性，第四季度和學齡期兒童分彆是肺炎支原體感染的高峰季節和高峰年齡組。兒科門診及病房為肺炎支原體抗體暘性率最高的標本來源。臨床醫生能夠根據肺炎支原體實驗室檢測結果選擇一線抗菌藥物併穫得良好的療效。
목적 분석폐염지원체감염혈청류행병학자료급수방평개부분양성자항균약물료효。방법용Serodia-Mycoll과립응집시제합검측3 134빈림상의사폐염지원체감염자적혈청항체，판단폐염지원체감염자병분석기류행병학자료，포괄항체총양성솔、남녀양성솔차이、계절양성솔차이、년령조양성솔차이급불동표본래원양성솔적차이등。수방평개부분양성자항균약물료효，통계사용항균약물적천수、불동항균약물사용정황，이급치유、호전급료효교차적비례등。결과 수집3 134빈림상의사폐염지원체감염자적혈청표본，기중350빈(11.2％)폐염지원체항체양성。녀성환자양성솔위12.3％( 198/1 604)，고우9.9％( 152/1 530)남성환자양성솔，차이유통계학의의(X2=4.58，P＜0.05)。폐염지원체항체양성솔최고계절재제4계도（10～12월），위13.2％ (95/719)；폐염지원체항체양성솔최고년령조위우5～9세，위32.8％ (45/137)。인과문진급인과병방위폐염지원체항체양성솔최고적표본래원，분별위27.9％ (56/201)화26.5％(60/226)。사구획득성폐염환자폐염지원체항체양성솔위28％ (7/25)，고우기타질병환자조。수방91례양성환자중，자출현림상증상지취진/항체검측적시간위5～120 d,평균24.2d。71례(78.0％)환자사용대배내지류항균약물치료，4례(4.4％)사용규낙동류항균약물，4례(4.4％)사용두포류항균약물치료，기여12례(13.2％)사용기타항균약물혹대증처리。상술항균약물치료시간3～21 d，평균8.2d。료효수방결과시치유35례(38.5％),호전50례(54.9％)，6례(6.6％)료효교차。결론폐염지원체항체양성솔녀성고우남성，제사계도화학령기인동분별시폐염지원체감염적고봉계절화고봉년령조。인과문진급병방위폐염지원체항체양성솔최고적표본래원。림상의생능구근거폐염지원체실험실검측결과선택일선항균약물병획득량호적료효。
Objective To analyze the seroepidemiologic of Mycoplasma pneumoniae infection and evaluate antibiotics medication of some positive patients by follow-up. Methods Serodia-MycolⅡ particle agglutination assay was used to detect serum antibodies against Mycoplasma pneumoniae in 3 134 clinically suspected infections. Mycoplasma pneumoniae infection was determined and seroepidemiologic was analyzed by results of the test, including positive antibody rates in whole subjects, in male or female groups, in different seasons or age groups as well as in different sources. Evaluate antibiotics medication of some positive patients by follow-up. The average days of medication were counted, different antibiotics medication and medication effect were analyzed. Results In 3 134 serum samples from clinically suspected Mycoplasma pneumoniae infections, 350 ( 11.2％ ) were tested with positive antibodies. The positive antibody rate in female patients was 12. 3％ ( 198/1 604), which was higher than 9. 9％ ( 152/1 530) in males (X2 =4. 58,P ＜0. 05). The peak season was found in the fourth quarter (October-December) with 13.2％ of positive antibody and the highest positive rate (32. 8％, 45/137 ) was found in school aged (5 -9 years old )children. Samples from pediatrics clinic and ward were tested to have highest positive rates ( 27. 9％ and 26. 5％, respectively ), comparing that from other sources. Infection due to Mycoplasma pneumoniae was identified in 28％ (7/25) of community-acquired pneumonia (CAP) patients, which is higher than other diseases. Based on the follow-up of 91 antibody positive patients, between 5 to 120 days ( mean 24. 2 days )were counted from appearance of clinical symptoms to clinic visiting/testing. 71 of 91 (78. 0％ ) patients was medicated with macrolide antibiotics, 4 (4. 4％ ) with quinolones, 4 (4. 4％ ) with cephalosporin, and the rest 12 ( 13.2％ ) patients were medicated with other antibiotics or only symptomatic treatment. The average period of antibiotics medication was between 3 to 21 days (mean 8. 2 days). Medication effect results by follow-up were cure in 35 ( 38. 5％ ), improvement in 50 (54. 9％ ), and poor responses in 6 (6. 6％ ).Conclusions Mycoplasma pneumoniae positive rate in female patients was higher than in males, and peak rate was found in the fourth quarter and in school aged children. Samples from pediatrics clinic and ward were tested to have highest positive rates. Physicians could choose first line antibiotics according to laboratory test results of Mycoplasma pneumoniae, and gain good effect.
