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目的研究新生儿肺炎(NP)的病原,探讨C反应蛋白(CRP)与不同病原所致NP的关系。方法气管吸取物细菌培养,间接荧光法进行咽拭子病毒抗原测定,PCR技术检测咽拭子肺炎支原体DNA,乳胶增强免疫比浊法检测血清中CRP含量。结果 167例NP中,细菌性肺炎41例,病毒性肺炎94例,肺炎支原体性肺炎12例,混合感染性肺炎20例。细菌性肺炎、肺炎支原体性肺炎和混合感染性肺炎患儿血清CRP阳性率明显高于正常新生儿(P均<0.05),细菌性肺炎患儿血清CRP阳性率明显高于肺炎支原体性肺炎患儿(P<0.05)。病毒性肺炎患儿血清CRP阳性率与正常新生儿间差异无统计学意义(P>0.05)。结论引起NP的病原有多种,而细菌是引起NP的主要病原,CRP的测定有助于细菌性肺炎的鉴别诊断及指导临床用药。
Objective To study the pathogen of neonatal pneumonia (NP) and to explore the relationship between C-reactive protein (CRP) and NP caused by different pathogens. Methods Bacterial culture of tracheal aspirate and indirect ELISA were used to detect the throat swab antigen. PCR was used to detect the DNA of mycoplasma pneumoniae, and latex enhanced immunoturbidimetry was used to detect the serum CRP level. Results In 167 NP cases, there were 41 cases of bacterial pneumonia, 94 cases of viral pneumonia, 12 cases of pneumonia mycoplasma pneumonia and 20 cases of mixed infectious pneumonia. The positive rate of CRP in children with bacterial pneumonia, mycoplasma pneumoniae pneumonia and mixed infectious pneumonia was significantly higher than that of normal neonates (all P <0.05). The positive rate of CRP in children with bacterial pneumonia was significantly higher than that of children with pneumonia mycoplasma pneumonia (P <0.05). The positive rate of serum CRP in children with viral pneumonia was not significantly different from that in normal newborns (P> 0.05). Conclusion The pathogens causing NP are many, while bacteria are the main causative agent of NP. The determination of CRP is helpful to the differential diagnosis of bacterial pneumonia and to guide the clinical medication.