摘要
目的:探讨肺炎衣原体检测对老年肺部感染治疗的临床价值。方法:收治肺炎衣原体肺部感染老年患者104例为观察组,选择体检者80例为对照组。均测定FEV_1、FVC和圣乔治呼吸问卷(SGRQ)评分。用微量免疫荧光(MIF)法检测肺炎衣原体(Cpn)抗体(Cpn-IgA、IgG和IgM)。结果:观察组Cpn的感染率为85.6%(89/104),对照组为15.0%(12/80)。代表急性感染的Cpn-IgM抗体检出率观察组显著高于对照组(P<0.001),代表慢性感染的Cpn-IgA和IgG抗体的检出率观察组也显著高于对照组(P<0.001)。阿奇霉素治疗后观察组患者的临床症状均有显著改善,SGRQ评分和FEV_1/FVC(%)显著增加,与此同时观察组只有Cpn-IgM滴度显著下降(P<0.001)。结论:在肺部感染的老年人中肺炎衣原体IgG抗体阳性率很高,临床上应高度重视,推荐应用大环内酯类抗生素治疗Cpn肺部感染。
Objective:To explore the clinical value of chlamydia pneumoniae detection in the treatment of elderly patients with pulmonary infection.Methods:104elderly patients with chlamydia pneumoniae infection were selected as the observation group,80healthy persons were selected as the control group,we measured the FEV1,FVC and scores of St Georges Respiratory Questionnaire(SGRQ).We used micro immunofluorescence(MIF)method to detect chlamydia pneumoniae(Cpn)antibodies(Cpn-IgA,IgG and IgM).Results:In the observation group,the infection rate of Cpn was85.6%(89/104),while the control group was15%(12/80).In the observation group,the detection rate of Cpn-IgM antibody representing acute infection was significantly higher than that of the control group(P<0.001),the detection rates of Cpn-IgA and IgG antibodies representing chronic infection were also significantly higher than those of the control group(P<0.001).After treatment with azithromycin,the clinical symptoms of the observation group were significantly improved:SGRQ score and FEV1/FVC(%)were significantly increased,at the same time,in the observation group,the titer of Cpn-IgM was significantly decreased(P<0.001).Conclusion:The positive rate of chlamydia pneumoniae IgG antibody was very high in the elderly with pulmonary infection,we should attach great importance to it,we recommend the use of macrolide antibiotics in the treatment of Cpn pulmonary infection.
作者
储德节
郭凤霞
朱小川
张燕子
胡辛
pulmonary infectionChu Dejie;Guo Fengxia;Zhu Xiaochuan;Zhang Yanzi;Hu Xin(Department of Respiratory Medicine,the Eighth People's Hospital of Shanghai City 200235)
出处
《中国社区医师》
2018年第35期111-112,共2页
Chinese Community Doctors
关键词
老年肺部感染
肺炎衣原体
阿奇霉素
Pulmonary infection in the elderly
Chlamydia pneumoniae
Azithromycin
