重症手足口病患儿合并肺炎支原体感染实验室检测指标对于临床诊断及治疗的提示性作用

doi:10.3969/j.issn.1006-7795.2015.04.017

首都医科大学学报 ›› 2015, Vol. 36 ›› Issue (4): 601-603.doi: 10.3969/j.issn.1006-7795.2015.04.017

重症手足口病患儿合并肺炎支原体感染实验室检测指标对于临床诊断及治疗的提示性作用

曲沛, 徐新民, 赵苗苗, 李娟, 宋淑静, 郭杰, 华文浩

首都医科大学附属北京地坛医院检验科, 北京 100015

收稿日期:2015-06-01 出版日期:2015-08-21 发布日期:2015-07-17
通讯作者: 华文浩 E-mail:dtjykhua@126com
基金资助:
综合医院急性严重呼吸道传染病病原学诊断研究(2014ZX10004005)。

Value of laboratory indicators for clinical diagnosis and treatment of the patients with severe hand, foot and mouth disease complicated with Mycoplasma pneumoniae infection

Qu Pei, Xu Xinmin, Zhao Miaomiao, Li Juan, Song Shujing, Guo Jie, Hua Wenhao

Department of Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

Received:2015-06-01 Online:2015-08-21 Published:2015-07-17
Supported by:
This study was supported by the Etiology Diagnosis Research of Acute Respiratory Which Serious Disease in General Hospital(2014ZX10004005).

摘要/Abstract

摘要：

目的探讨肠道病毒71型合并肺炎支原体感染的重症手足口患儿的检测指标对于临床诊断及治疗是否起到提示作用。方法收集2014年3月至8月于首都医科大学附属北京地坛医院住院的手足口病患儿100例,非手足口病患儿50例,对其粪便标本采用荧光定量RT-PCR方法检测,得出核酸定性结果。对其血清标本采用被动凝集法检测以得出肺炎支原体抗体效价。分析肺炎支原体感染在手足口病组和非手足口病组中的差异,探讨肠道病毒71型合并肺炎支原体感染与手足口病严重程度的相关性。结果重症手足口病组患儿的肺炎支原体阳性率(76%)高于轻症手足口病组患儿的肺炎支原体阳性率(48%),差异有统计学意义(χ²=8.319,P=0.004)。结论肠道病毒71型阳性合并肺炎支原体感染的重症手足口病患儿,应在临床诊治中引起关注。对于降低重症手足口病患儿向危重症的转化具有提示意义。

关键词: 重症手足口病, 肠道病毒71型, 肺炎支原体, 合并感染

Abstract:

Objective To investigate the value of laboratory indicators in clinical diagnosis and treatment of the patients with severe hand, foot and mouth disease(HFMD) commplicated with enterovirus 71(EV71) and Mycoplasma pneumoniae infection. Methods The data of 100 cases with HFMD and 50 cases with non-HFMD were collected in Beijing Ditan Hospital from March 2014 to August 2014. Real-time fluorescence quantitative PCR(RT-PCR) method was used to test the DNA in stool samples and obtained qualitative results. Passive agglutination test was performed to detect Mycoplasma pneumoniae antibody titers in serum. Then, we analyzed the possibility of Mycoplasma pneumoniae infection in HFMD group and non-HFMD group, and explored the correlation of EV71 infection complicated with Mycoplasma pneumoniae infection and the severity of HFMD. Results The positive rate of Mycoplasma pneumoniae infection in the severe HFMD group(76%) was significantly higher than that in the mild HFMD group(48%, χ²=8.319, P=0.004). Conclusion Close teention should be paid to severe HFMD patients with the EV71 infection complicated with Mycoplasma pneumoniae infection. This is critically important for reducing the severity of HFMD.

Key words: severe hand foot and mouth disease, enterovirus 71, Mycoplasma pneumoniae, concurrent infection

中图分类号:

R446

曲沛, 徐新民, 赵苗苗, 李娟, 宋淑静, 郭杰, 华文浩. 重症手足口病患儿合并肺炎支原体感染实验室检测指标对于临床诊断及治疗的提示性作用[J]. 首都医科大学学报, 2015, 36(4): 601-603.

Qu Pei, Xu Xinmin, Zhao Miaomiao, Li Juan, Song Shujing, Guo Jie, Hua Wenhao. Value of laboratory indicators for clinical diagnosis and treatment of the patients with severe hand, foot and mouth disease complicated with Mycoplasma pneumoniae infection[J]. Journal of Capital Medical University, 2015, 36(4): 601-603.

参考文献

[1] Richardson H B Jr, Leibovitz A. "Hand, foot and mouth disease" in children: an epidemic associated with coxsackie virus A-16[J]. J Pediatr, 1965,67:6-12.
[2] 陆国平,李兴旺,吕勇,等.危重症手足口病(EV71感染)诊治体会[J].中国小儿急救医学,2008,15(3):217-220.
[3] 杜开先,张艳,贾天明,等.儿童重症手足口病治疗的体会[J].医学与哲学,2011,32(5):69-69.
[4] Li Y, Dang S, Deng H, et al. Breastfeeding, previous Epstein-Barr virus infection, Enterovirus 71 infection, and rural residence are associated with the severity of hand, foot, and mouth disease[J]. Eur J Pediatr, 2013,172(5):661-666.
[5] 中华人民共和国卫生部.手足口病诊疗指南(2010年版)[EB/OL].http://www.nhfpc.gov.cn/yzygj/s3593g/201306/6d935c0f43cd4a1fb46f8f71acf8e245.shtml.
[6] 中华人民共和国国家卫生和计划生育委员会.2014年7月全国法定传染病疫情概况[EB/OL].http://www.chinacdc.cn/tjsj/fdcrbbg/201408/t20140827_101835.htm.
[7] 顾红岩,李兴旺. EV71和CoxA16 病毒的区别与联系[J].中华实验和临床感染病杂志:电子版,2014,8(1):132-136.
[8] 刘虹,王春妍.手足口病患儿免疫功能临床分析[J].天津医科大学学报,2009,15(3):503-504.
[9] Gilbert G L, Dickson K E, Waters M J, et al. Outbreak of enterovirus 71infection in Victoria, Australia, with a high incidence of neurologic involvement[J]. Pediatr Infect Dis J, 1988,7(7):484-488.
[10] 吴清岩.重症手足口病330例临床分析[J].中国煤炭工业医学杂志,2012,15(12):1862-1864.
[11] Chen S P, Huang Y C, Li W C, et al. Comparison of clinical features between coxsackievirus A2 and enterovirus 71 during the enterovirus outbreak in Taiwan, 2008 A children's hospital experience[J]. J Microbiol Immunol Infect, 2010,43(2):99-104.
[12] 田玲,汪楠,张宏梁,等.手足口病(EV71)防治[J].首都医科大学学报,2008,29(3):253-256.

重症手足口病患儿合并肺炎支原体感染实验室检测指标对于临床诊断及治疗的提示性作用

Value of laboratory indicators for clinical diagnosis and treatment of the patients with severe hand, foot and mouth disease complicated with Mycoplasma pneumoniae infection

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