CAJ | 학술논문

目的：探讨9项呼吸道病原抗体检测在急性气管‐支气管炎患儿诊断中的价值。方法选取清远市妇幼保健院门诊部和住院部急性气管‐支气管炎患儿269例，其中2～12月患儿67例，＞1～4岁患儿86例，大于4岁患儿116例，全部患儿采用间接免疫荧光法检测9项呼吸道病原 IgM 抗体，观察单项及多项病原抗体检测阳性的分布情况，并分析不同年龄段患儿9项呼吸道病原抗体阳性率的差异，评价其在指导临床抗菌药物应用中的价值。结果9项呼吸道病原抗体检测阳性率为52．42％，其中单项呼吸道病原抗体阳性率为44．61％，多项病原抗体检测阳性率为7．81％。肺炎支原体抗体阳性率为26．39％，明显高于乙型流感病毒抗体阳性率7．43％、肺炎衣原体抗体阳性率4．83％，嗜肺军团菌抗体阳性率4．09％，差异有统计学意义（P ＜0．05）。不同年龄段抗体阳性率比较差异均有统计学意义（P＜0．05）。61例肺炎支原体抗体、11例嗜肺军团菌抗体和5例 Q 热立克次体阳性患儿均应用阿奇霉素治疗有效，肺炎支原体对气管‐支气管炎的诊断灵敏度、特异度、Kappa 值和受试者操作特征曲线下面积明显高于乙型流感病毒和肺炎衣原体。结论9项呼吸道病原抗体检测在急性气管‐支气管炎患儿诊断中阳性率较高，在辅助急性气管‐支气管炎诊断和指导抗菌药物应用中具有重要的意义。
목적：탐토9항호흡도병원항체검측재급성기관‐지기관염환인진단중적개치。방법선취청원시부유보건원문진부화주원부급성기관‐지기관염환인269례，기중2～12월환인67례，＞1～4세환인86례，대우4세환인116례，전부환인채용간접면역형광법검측9항호흡도병원 IgM 항체，관찰단항급다항병원항체검측양성적분포정황，병분석불동년령단환인9항호흡도병원항체양성솔적차이，평개기재지도림상항균약물응용중적개치。결과9항호흡도병원항체검측양성솔위52．42％，기중단항호흡도병원항체양성솔위44．61％，다항병원항체검측양성솔위7．81％。폐염지원체항체양성솔위26．39％，명현고우을형류감병독항체양성솔7．43％、폐염의원체항체양성솔4．83％，기폐군단균항체양성솔4．09％，차이유통계학의의（P ＜0．05）。불동년령단항체양성솔비교차이균유통계학의의（P＜0．05）。61례폐염지원체항체、11례기폐군단균항체화5례 Q 열립극차체양성환인균응용아기매소치료유효，폐염지원체대기관‐지기관염적진단령민도、특이도、Kappa 치화수시자조작특정곡선하면적명현고우을형류감병독화폐염의원체。결론9항호흡도병원항체검측재급성기관‐지기관염환인진단중양성솔교고，재보조급성기관‐지기관염진단화지도항균약물응용중구유중요적의의。
Objective To investigate the value of nine respiratory tract antibodies detection in the diagnosis of children with a‐cute tracheobronchitis .Methods A total of 269 cases with acute tracheobronchitis were selected in outpatient department of Mater‐nal and Child Care Hospital of Qingyuan ,including 67 children for 2 - 12 months ,86 children for > 1 - 4 years old ,116 children for more than 4 years ,nine respiratory pathogens IgM antibodies were detected by indirect immunofluorescence technique ,the single and combined positive rate of the nine respiratory pathogen antibodies were observed ,and the positive rates of nine respiratory pathogens antibodies of children at different ages were analyzed ,the clinical antibiotics application value was evaluated .Results The positive rate of nine detection of respiratory pathogens antibodies was 52 .42% ,the positive rate of individual respiratory patho‐gen antibody was 44 .61% ,the positive rate of various pathogenic antibody detection was 7 .81% .The positive rate of mycoplasma pneumoniae antibody was 26 .39% ,which was significant higher than 7 .43% of influenza B virus antibody ,4 .83% of chlamydia pneumoniae antibody ,and 4 .09% of legionella pneumophila antibody ,the differences were significant (P< 0 .05) .The differences of antibody positive rates in different age groups were significant (P < 0 .05) .61 children with mycoplasma pneumoniae antibody ,11 children with legionella .pneumophila antibody and 5 children with Q rickettsia positive were treated by azithromycin effectively . The diagnostic sensitivity ,specificity ,Kappa value and under area of receiver operating characteristic curve of mycoplasma pneu‐moniae were significant higher than influenza B virus and chlamydia pneumoniae antibody .Conclusion The diagnosis positive rate of nine respiratory pathogenic antibodies detection to children with acute tracheobronchitis is high ,which has important significance in the auxiliary acute tracheobronchitis diagnosis and guiding the antibiotic application .