儿童非典型肺炎诊断与鉴别诊断方法的探讨(附87例临床分析)

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目的 探讨儿童非典型肺炎诊断与鉴别诊断方法 ,主要是与SARS进行鉴别。方法 对 2 0 0 3年 4月~ 5月儿童非典型肺炎 87例采用隔离、ELISA法做肺炎支原体IgM、衣原体IgM、IgG ,柯萨奇病毒BIgM ,巨细胞病毒IgM。乳胶凝集法查EB病毒抗原 ,免疫金标法查EB病毒抗体。酶联免疫法查SARS冠状病毒抗体IgM ,并分析临床资料。结果  87例非典型肺炎中支原体肺炎 80例 ,衣原体肺炎 2例 ,EB病毒肺炎 5例。结论 目前SARS的实验诊断技术尚不普及 ,为了减少“疑似”和避免浪费 ,应尽可能做排除SARS的实验。而这些病原的抗原、抗体检查技术均已成熟 ,这些方法的建立和应用对排除SARS和AP的鉴别诊断有很大的价值。 Objective To investigate the diagnosis and differential diagnosis of atypical pneumonia in children, mainly to identify with SARS. Methods Isolation and isolation of 87 cases of atypical pneumonia in children from April to May in 2003 were performed. Mycoplasma pneumoniae IgM, Chlamydia IgM, IgG, Coxsackievirus BIgM and cytomegalovirus IgM were detected by ELISA. Latex agglutination test EB virus antigens, immune gold standard search EB virus antibodies. Detection of SARS coronavirus antibody IgM by enzyme-linked immunosorbent assay and analysis of clinical data. Results Eighty-eight cases of mycoplasma pneumonia, two cases of chlamydia pneumonia and five cases of Epstein-Barr virus pneumonia were found in 87 cases of SARS. Conclusion At present, the technology of experimental diagnosis of SARS is not yet widely used. In order to reduce the “suspicion” and avoid the waste, SARS experiments should be done as much as possible. The pathogens of the antigen, antibody testing techniques have matured, the establishment and application of these methods to exclude SARS and AP differential diagnosis of great value.
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