Li Chang-Zhen, Rao Jing-Jing, Wang Rong, Sun Hong, Ai Hong-Wu
Department of Clinical Laboratory, Wuhan Medical Care Center for Women and Children, Wuhan 430016, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2012 Nov;14(11):834-7.
To investigate the association of non-bacterial respiratory pathogens with asthmatic diseases in children, and the clinical significance of total serum IgE levels and peripheral eosinophil count in infection with non-bacterial respiratory pathogens.
Indirect immunofluorescence assay was used to detect IgM antibodies against nine types of non-bacterial respiratory pathogens in the sera of 490 children with asthmatic diseases between September 2010 and September 2011. Pathogens were analyzed and total serum IgE levels and peripheral eosinophil count were measured in IgM-positive cases.
Of the 490 children with asthmatic diseases, 47.6% (233 cases) were positive with IgM antibodies against non-bacterial respiratory pathogens, the most common being Mycoplasma pneumoniae (MP) (25.3%), followed by adenovirus (ADV) (8.9%) and influenza B virus (Flu B) (8.8%). Thirty-six cases suffered from co-infection of two or more non-bacterial pathogens, mainly comprising MP and other pathogens (94%). There were significant differences in the total detection rate of IgM antibodies among all age groups (0-30 days: 50.0%; 1-6 months: 67.3%; 0.5-1 year: 33.1%; 1-3 years: 57.3%; 3-8.9 years: 61.7%). The positive rate of IgM antibodies against respiratory pathogens was highest in children with bronchial asthma, followed by children with asthmatic bronchitis, and it was lowest in children with bronchiolitis. IgM-positive children had significantly decreased blood eosinophils and significantly increased total serum IgE levels.
The main non-bacterial respiratory pathogens include MP, ADV and Flu B in children with asthmatic diseases, and co-infection of MP and other non-bacterial pathogens is common. Infants aged 1 to 6 months have a higher infection rate than other age groups. Monitoring the changes in total serum IgE levels and peripheral eosinophil count has great significance for the clinical diagnosis and treatment of asthmatic diseases in children.
探讨儿童非细菌性呼吸道病原体与哮喘性疾病的关联,以及血清总IgE水平和外周血嗜酸性粒细胞计数在非细菌性呼吸道病原体感染中的临床意义。
采用间接免疫荧光法检测2010年9月至2011年9月期间490例哮喘性疾病患儿血清中9种非细菌性呼吸道病原体的IgM抗体。对病原体进行分析,并检测IgM阳性病例的血清总IgE水平和外周血嗜酸性粒细胞计数。
490例哮喘性疾病患儿中,47.6%(233例)非细菌性呼吸道病原体IgM抗体阳性,最常见的是肺炎支原体(MP)(25.3%),其次是腺病毒(ADV)(8.9%)和乙型流感病毒(Flu B)(8.8%)。36例患儿发生两种或两种以上非细菌性病原体混合感染,主要为MP与其他病原体混合感染(94%)。各年龄组IgM抗体总检出率差异有统计学意义(0~30天:50.0%;1~6个月:67.3%;0.5~1岁:33.1%;1~3岁:57.3%;3~8.9岁:61.7%)。呼吸道病原体IgM抗体阳性率在支气管哮喘患儿中最高,其次是喘息性支气管炎患儿,在毛细支气管炎患儿中最低。IgM阳性患儿血嗜酸性粒细胞明显减少,血清总IgE水平明显升高。
哮喘性疾病患儿主要的非细菌性呼吸道病原体包括MP、ADV和Flu B,MP与其他非细菌性病原体混合感染常见。1~6个月婴儿感染率高于其他年龄组。监测血清总IgE水平和外周血嗜酸性粒细胞计数变化对儿童哮喘性疾病的临床诊断和治疗具有重要意义。