儿童哮喘急性发作与肺炎衣原体感染的临床研究

Evaluation of association between an acute attack of childhood bronchial asthma and Chlamydia pneumoniae infection

摘要:

目的：对儿童哮喘急性发作病例与肺炎衣原体(CP)感染相关性进行临床研究。方法：采用固相酶联免疫吸附(ELISA)方法,检测120例儿童哮喘急性发作期的肺炎衣原体血清特异性CP-IgM,CP-IgG抗体,探讨哮喘患儿急性发作及临床控制与肺炎衣原体感染的关系。以健康体检者作为对照。结果：120例儿童哮喘急性发作病例中,检测出CP-IgM阳性22例,阳性率18.3%,CP-IgG阳性32例,阳性率26.7%,与健康对照组比较差异有显著性(P<0.01)。CP感染的32例哮喘病人中有15例(46.9%)单纯给予吸入治疗获良好哮喘控制;有17例(53.1%)给予阿奇霉素足疗程治疗,配合吸入治疗,哮喘急性发作方得以完全控制。结论：儿童哮喘急性发作与肺炎衣原体感染有关,应作肺炎衣原体相关特异性抗体检测,并须配合大环内酯类药物治疗及规范吸入激素治疗,以早日达到哮喘的完全控制。

Abstract:

OBJECTIVE: To identify whether there is an association between an acute attack of childhood bronchial asthma and Chlamydia pneumoniae(CP) infection. METHODS: Serum specific antibodies IgM and IgG to CP were detected by ELISA in 120 asthmatic children with an acute attack and 82 healthy children. RESULTS: Anti-CP IgM was demonstrated in 22 cases(18.3%) and anti-CP IgG was demonstrated in 32 cases(26.7%) out of the 120 asthmatic patients.The incidence of CP infection in asthmatic children was significantly higher than that in healthy controls(3.7%)(P<0.01). Glucocorticoid inhalation treatment alone resulted in a remission of an acute attack of asthma in 15 cases out of the 32 cases with CP infection, but 17 cases required glucocorticoid inhalation treatment together with anti-CP infection treatment(macrolide antibiotics,eg.azithromycin) for remission of asthma attack. CONCLUSIONS: There may be a link between an acute attack of childhood asthma and CP infection.It is thus necessary to detect the CP-specific antibodies in asthmatic children for proper treatment.