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PCR和血清学联合检测急性呼吸道感染患者肺炎衣原体感染的临床研究

Assessment of polymerase chain reaction and serology for detection of chlamydi a pneumoniae in patients with acute respiratory tract infection

摘要:

目的 了解成人呼吸道感染患者急性肺炎衣原体感染的发病率及临床特征。方法 呼吸道感染住院患者110例,同时采集痰和咽拭子标本应用聚合酶链式反应(PCR)检测肺炎衣原体DNA及采取静脉血检测肺炎衣原体IgG和IgM抗体。结果 本组呼吸道感染患者特异性IgG抗体的阳性率为70%。17例(15.5%)有肺炎衣原体近期感染的急性抗体,12例(10.9%)痰和(或)咽拭子肺炎衣原体PCR检测结果阳性,联合应用两种方法的阳性率为22.7%(25/110例)。肺炎衣原体急性感染以支气管哮喘急性发作、肺炎、COPD急性加重和急性支气管炎患者多见(分别为57.1%、35.0%、25.9%和25.0%),其临床表现无特征性。结论 本组成人呼吸道感染患者肺炎衣原体急性感染的发病率较高,提示肺炎衣原体是呼吸道感染的重要致病原。

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Objective To study Chlamydia pneumoniae (C. pneumoniae) infection in 110 patients w ith respiratory tract infection admitted to our hospital from January to Decembe r 1995 in Nanjing.Methods Sputum and throat swab specimens were taken and C.pneumoniae DNA was detected b y using polymerase chain reaction (PCR) with the HM-1-HR-1 primer pair. At the same time, serum samples were taken and immunoglobulin G and M (IgG and Ig M) fractions of antibodies to C.pneumoniae were studied by microimmunofluo rescence test.Results Prevalence of specific IgG was 70% in patients with respiratory tract infection . Seventeen patients (15.5 %) were serologically diagnosed as having recent C.pneumoniae infections and 12 patients (10.9%) had positive PCR in sp utum and/or swab specimens. The total positive rate was 22.7% (25/110) dete cted by PCR combined with serological tests. Acute infection of C.pneumoniae was common in patients with asthma (57.1%), pneumonia (35.0%), COPD (25.9%) and bronchitis (25.0%). Clinical features between C.pneumoni ae infection and non-C.pneumonia infection showed no significant differences.Conclusions Chamydia pneumoniae is an important pathogen that causes infection of the human respiratory tract and attention should be drawn to this special illness.

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