中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
12期
919-923
,共5页
崔京涛%闫文娟%倪安平%孔令君%陈兰兰
崔京濤%閆文娟%倪安平%孔令君%陳蘭蘭
최경도%염문연%예안평%공령군%진란란
衣原体,肺炎%血清流行病学研究%荧光抗体技术
衣原體,肺炎%血清流行病學研究%熒光抗體技術
의원체,폐염%혈청류행병학연구%형광항체기술
Chlamydia pneumoniae%Seroepidemiologic studies%Fluorescent antibody technique
目的 了解最近5年临床送检标本血清肺炎衣原体抗体检测结果及其流行病学情况.方法 对北京协和医院2008年5月至2013年9月采用微量免疫荧光法检测的7 802份血清标本肺炎衣原体IgG和IgM抗体结果进行回顾性分析.根据IgG和IgM抗体以及滴度判断肺炎衣原体既往感染或近期感染.分析年龄、性别等临床因素与肺炎衣原体抗体滴度的关系.结果 (1)肺炎衣原体既往感染:IgG抗体滴度≥1∶16且＜1∶512(阳性)率为87.5％(6 827/7 802),其中2～4岁组阳性率最低[50.6％ (78/154)],70岁以上组阳性率最高[98.7％(1 277/1 294)].肺炎衣原体IgG抗体阳性患者中,男性抗体滴度高于女性抗体滴度(几何均数:45.8比41.9),差异有统计学意义(P=0.000 1).(2)肺炎衣原体近期感染:肺炎衣原体IgG抗体≥1∶512或IgM滴度≥1∶16或急性期和恢复期双份血清抗体阳转或滴度4倍及以上升高,总体近期感染率为3.6％(282/7 802),其中＜2岁组感染率最低[0.5％(2/417)],10 ～14岁组感染率最高[6.7％ (24/357)].如果IgM作为唯一的近期感染标准可能有高达68.1％(192/282)漏检.仅自身免疫病患者和肺部感染或肺部阴影患者中肺炎衣原体近期感染率高于总体近期感染率[7.1％(24/336)和4.7％(69/1 467)比3.6％,P=0.000 4、0.014 0].结论 肺炎衣原体IgG抗体阳性率非常高,男性患者IgG抗体滴度明显高于女性;如果以IgM抗体作为肺炎衣原体近期感染率唯一判定标准可造成漏检.
目的 瞭解最近5年臨床送檢標本血清肺炎衣原體抗體檢測結果及其流行病學情況.方法 對北京協和醫院2008年5月至2013年9月採用微量免疫熒光法檢測的7 802份血清標本肺炎衣原體IgG和IgM抗體結果進行迴顧性分析.根據IgG和IgM抗體以及滴度判斷肺炎衣原體既往感染或近期感染.分析年齡、性彆等臨床因素與肺炎衣原體抗體滴度的關繫.結果 (1)肺炎衣原體既往感染:IgG抗體滴度≥1∶16且＜1∶512(暘性)率為87.5％(6 827/7 802),其中2～4歲組暘性率最低[50.6％ (78/154)],70歲以上組暘性率最高[98.7％(1 277/1 294)].肺炎衣原體IgG抗體暘性患者中,男性抗體滴度高于女性抗體滴度(幾何均數:45.8比41.9),差異有統計學意義(P=0.000 1).(2)肺炎衣原體近期感染:肺炎衣原體IgG抗體≥1∶512或IgM滴度≥1∶16或急性期和恢複期雙份血清抗體暘轉或滴度4倍及以上升高,總體近期感染率為3.6％(282/7 802),其中＜2歲組感染率最低[0.5％(2/417)],10 ～14歲組感染率最高[6.7％ (24/357)].如果IgM作為唯一的近期感染標準可能有高達68.1％(192/282)漏檢.僅自身免疫病患者和肺部感染或肺部陰影患者中肺炎衣原體近期感染率高于總體近期感染率[7.1％(24/336)和4.7％(69/1 467)比3.6％,P=0.000 4、0.014 0].結論 肺炎衣原體IgG抗體暘性率非常高,男性患者IgG抗體滴度明顯高于女性;如果以IgM抗體作為肺炎衣原體近期感染率唯一判定標準可造成漏檢.
목적 료해최근5년림상송검표본혈청폐염의원체항체검측결과급기류행병학정황.방법 대북경협화의원2008년5월지2013년9월채용미량면역형광법검측적7 802빈혈청표본폐염의원체IgG화IgM항체결과진행회고성분석.근거IgG화IgM항체이급적도판단폐염의원체기왕감염혹근기감염.분석년령、성별등림상인소여폐염의원체항체적도적관계.결과 (1)폐염의원체기왕감염:IgG항체적도≥1∶16차＜1∶512(양성)솔위87.5％(6 827/7 802),기중2～4세조양성솔최저[50.6％ (78/154)],70세이상조양성솔최고[98.7％(1 277/1 294)].폐염의원체IgG항체양성환자중,남성항체적도고우녀성항체적도(궤하균수:45.8비41.9),차이유통계학의의(P=0.000 1).(2)폐염의원체근기감염:폐염의원체IgG항체≥1∶512혹IgM적도≥1∶16혹급성기화회복기쌍빈혈청항체양전혹적도4배급이상승고,총체근기감염솔위3.6％(282/7 802),기중＜2세조감염솔최저[0.5％(2/417)],10 ～14세조감염솔최고[6.7％ (24/357)].여과IgM작위유일적근기감염표준가능유고체68.1％(192/282)루검.부자신면역병환자화폐부감염혹폐부음영환자중폐염의원체근기감염솔고우총체근기감염솔[7.1％(24/336)화4.7％(69/1 467)비3.6％,P=0.000 4、0.014 0].결론 폐염의원체IgG항체양성솔비상고,남성환자IgG항체적도명현고우녀성;여과이IgM항체작위폐염의원체근기감염솔유일판정표준가조성루검.
Objective To detect serum Chlamydia pneumoniae (C.pneumonia) antibodies and analyze the epidemiologic data.Methods Micro-immunofluorescence(MIF) was used to detect IgG and IgM antibodies against C.pneumoniae in 7 802 serum specimens from May 2008 to September 2013.C.pneumoniae past or recent infections were determined based on specific IgG and IgM antibodies and their titers.The analysis of relationship between age,gender and other clinical factors associated with antibody titers was performed.Results The positive rate of C.pneumonia IgG antibodies(≥ 1∶16 and ＜ 1∶512) was 87.5％ (6 827/7 802).And the lowest rate of 50.6％ (78/154) was shown in patients of 2-4 years age group while the highest rate of 98.7％ (1 277/1 294) in those above 70 years old.The average geometric mean titer (GMT) of C.pneumonia IgG antibodies was 43.9.GMT in males was significantly higher than that in females (45.8 vs 41.9,P =0.000 1).And 282 (3.6％) patients were diagnosed with recent C.pneumoniae infection(IgG≥ 1∶512 or IgM≥ 1∶16 or acute and convalescent serum antibody titers turned to positive or four times and more elevated).The lowest rate of 0.5 ％ (2/417)was detected in ＜ 2-year-old patients while the highest rate of 6.7％ (24/357)in 10-14-year-old group patients.The miss ratio was as high as 68.1％ (192/282)if C.pneumoniae IgM antibody was used as an only criteria for C.pneumoniae recent infection.The recent infection rates in patients with autoimmune diseases (7.1％ (24/336)) and those with pneumonia/chest radiological shadow findings (4.7％ (69/1 467)) were statistically higher than the average rate (3.6％) of total population(P =0.000 4,0.014 0).Conclusions The positive rate of C.pneumonia IgG antibody is quite high in the population.And the GMT of C.pneumoniae IgG antibody in males is significantly high than that in females.Recent C.pneumonia infection is to be missed if IgM antibody is used as a sole criterion.
