反复呼吸道感染患儿的病原菌分布与免疫功能监测

发布时间：2018-04-25 16:10

本文选题：儿童 + 反复呼吸道感染　；参考：《中华医院感染学杂志》2016年19期

【摘要】：目的探讨反复呼吸道感染(RRI)患儿的病原菌分布与免疫功能状况,以辅助临床治疗并降低感染率。方法选择2014年1月-2015年12月在医院就诊RRI患儿54例纳入观察组,另选同期在医院进行健康体检的儿童50名为对照组,对比不同年龄RRI患儿的病原菌分布和重复感染的情况,比较两组受试者的细胞免疫指标,包括CD_3~+、CD_4~+、CD_8~+、CD_4~+/CD_8~+;体液免疫指标,包括免疫球蛋白(IgA、IgM、IgG)、补体(C_3、C_4);炎性细胞因子,包括白细胞介素-4(IL-4)、白细胞介素-10(IL-10)、白细胞介素-12(IL-12)。结果≤5岁患儿共检出病原菌103株,以肺炎克雷伯菌,大肠埃希菌,金黄色葡萄球菌为主,分别占17.48%,16.50%,15.53%,5岁患儿共检出病原菌117株,以大肠埃希菌,肺炎克雷伯菌,金黄色葡萄球菌为主,分别占17.09%,15.38%,14.53%;5岁患儿的重复感染率与5岁患儿相比,差异无统计学意义;观察组CD_3~+及CD_4~+/CD_8~+较对照组明显降低,CD8+较对照组明显升高,差异均有统计学意义(P0.05);观察组IgM、IgG及补体C3较对照组明显降低,差异均有统计学意义(P0.05);观察组IL-4、IL-10较对照组明显升高,而IL-12较对照组明显降低,差异均有统计学意义(P0.05)。结论 RRI患儿的细胞免疫及体液免疫功能均较为低下,炎性因子水平处于异常状态,发生重复感染的病原菌分布以大肠埃希菌和肺炎克雷伯菌为主,临床应重点监测感染症状,从而更好地给予治疗。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria and immune function in children with recurrent respiratory tract infection (RRI) in order to assist clinical treatment and reduce infection rate. Methods from January 2014 to December 2015, 54 children with RRI were enrolled in the observation group, and 50 children who underwent physical examination in hospital were selected as control group. The distribution of pathogens and repeated infection in children with RRI of different ages were compared. The cellular immunity indexes of the two groups were compared, including the levels of CD3 / CD4 / CD8 / CD4 / CD8; humoral immunological indexes, including IgA- IgMN IgGG, complement C3- C4; inflammatory cytokines, including interleukin-4IL-4, interleukin-10- (IL-10), interleukin-12 (IL-12). Results A total of 103 strains of pathogenic bacteria were detected in children under 5 years old. Klebsiella pneumoniae, Escherichia coli and Staphylococcus aureus were the main pathogens, accounting for 17.48% 16.50% and 15.53 years old respectively. 117 strains of pathogenic bacteria were detected in children aged below 5 years, including Escherichia coli and Klebsiella pneumoniae. The repeated infection rate of staphylococcus aureus in children aged 5 years old was not significantly different from that in children aged 5 years old, and CD3 ~ and CD4 ~ / CD8 ~ in the observation group were significantly lower than those in the control group, and the number of CD8 in the observation group was significantly lower than that in the control group, and that in the control group was significantly higher than that in the control group. The differences were statistically significant (P 0.05), IgM IgG and complement C 3 in the observation group were significantly lower than those in the control group (P 0.05), IL-4 IL-10 in the observation group was significantly higher than that in the control group, and IL-12 was significantly lower than that in the control group (P 0.05). Conclusion the cellular and humoral immunity of children with RRI is low, the level of inflammatory factors is abnormal, the main pathogens of repeated infection are Escherichia coli and Klebsiella pneumoniae. In order to better give treatment.
【作者单位】：临沂市妇女儿童医院;
【基金】：山东省自然科学基金资助项目(ZR2013HL020)
【分类号】：R725.6;R446.1

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