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[血清肺炎衣原体抗体检测及5年流行病学数据分析]

[Detection of serum Chlamydia pneumoniae antibodies and analysis of epidemiologic data in 5 years].

作者信息

Cui Jingtao, Yan Wenjuan, Ni Anping, Kong Lingjun, Chen Lanlan

机构信息

Department of Clinical Laboratories, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.

Department of Clinical Laboratories, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China. Email:

出版信息

Zhonghua Yi Xue Za Zhi. 2014 Apr 1;94(12):919-23.

Abstract

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.

摘要

目的

检测血清肺炎衣原体(C. pneumoniae)抗体并分析流行病学数据。

方法

采用微量免疫荧光法(MIF)检测2008年5月至2013年9月期间7802份血清标本中抗肺炎衣原体的IgG和IgM抗体。根据特异性IgG和IgM抗体及其滴度确定肺炎衣原体既往或近期感染情况。分析年龄、性别及其他与抗体滴度相关的临床因素之间的关系。

结果

肺炎衣原体IgG抗体阳性率(≥1:16且<1:512)为87.5%(6827/7802)。2 - 4岁年龄组患者的最低阳性率为50.6%(78/154),而70岁以上患者的最高阳性率为98.7%(1277/1294)。肺炎衣原体IgG抗体的平均几何平均滴度(GMT)为43.9。男性的GMT显著高于女性(45.8对41.9,P = 0.0001)。282例(3.6%)患者被诊断为近期肺炎衣原体感染(IgG≥1:512或IgM≥l:16或急性期和恢复期血清抗体滴度转为阳性或升高四倍及以上)。<2岁患者的最低感染率为0.5%(2/417),而10 - 14岁组患者的最高感染率为6.7%(24/357)。若仅将肺炎衣原体IgM抗体作为近期肺炎衣原体感染的唯一标准,漏诊率高达68.1%(192/282)。自身免疫性疾病患者(7.1%(24/336))和有肺炎/胸部影像学阴影表现患者(4.7%(69/1467))的近期感染率在统计学上高于总体平均感染率(3.6%)(P = 0.0004,0.0140)。

结论

人群中肺炎衣原体IgG抗体阳性率相当高。男性肺炎衣原体IgG抗体的GMT显著高于女性。若仅以IgM抗体作为唯一标准,近期肺炎衣原体感染易被漏诊。

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