The elderly check in the mycoplasma pneumonia laboratory and auxiliary examination _'s symptom

The elderly check in the mycoplasma pneumonia laboratory and auxiliary examination _'s symptom

Check in the laboratory: Acute blood routine examinations reveal the total number of leucocytes rises and takes lymphocyte as the core normally and slightly; Have, present leukemia kind react and leucocyte reduce disease about 2/3 the intersection of case and the intersection of erythrocyte and sedimentation rate increase (> 40mm/h) fast occasionally ; The urine tests and checks normally or has a small amount of proteinuria; There can also be transaminase to rise while checking in liver function; Thorax accumulate liquid take the form of slurries nature or slurry courageous and upright proteins 32- 49g/L, once there were persons who isolates mycoplasma in the liquid of afterbirth
1.Aetiology can do the pneumonia mycoplasma and separate and train the sample to come from swallowing and secreting things (throat swab partly while checking, swallow and wash the thing out) The phlegm bronchus alveolus irritates lotion,etc., after the antibody appears, it is still very positive to train. Meninx encephalitis pericarditis and big bubble myringitis person can adopt the cerebrospinal fluid (CSF) pericardium to accumulate the liquid or auris media secretion to train separately, can also isolate the mycoplasma. It is difficult to popularize and apply that aetiology is checked reliable and specific and high but time-consuming and strenuous, helpless to the diagnosis in early days of this disease.
2.Serology check, make a definite diagnosis of whom mycoplasma infect commonsense method get up about 2/3 patient condense, collect, test masculine gender, drip degrees of the intersection of result and price, greater than 1 2 week after the disease the most: 32,Had this method of diagnosing value to continue to use clinically for many years even more when dripping degree and rising progressively particularly, because of condensing and collecting antibodies (IgM antibody against antigen of red cell) Appear earlier (have illness coming on for first weekend) ,The positive rate is higher (50%- 75%) Drop rapidly after dropping too fast (4 weeks) ,So still can yet be regarded as one at present simply and conveniently and fast, but practical more early diagnostic method must combine clinical and other serology and measure to judge if the complement combine and test the indirect blood to congeal and test the indirect fluorogenic antibody to determine, enzyme is united the immunity is absorbed and tested and growth is suppressed and tested etc., because all antigen is prepared from the mycoplasma lipid extracts of pneumonia, have specific the intersection of diagnosis and value enzyme unite immunity absorb, test most sensitive among them, help to judge that was infected with recently; Indirect fluorogenic antibody determine IgG antibody appear late, keep time to be long to suitable for, carry on epidemiology investigate; The indirect blood congeals the law IgM antibody to appear early, disappear fast, relatively practical; Growth inhibits testing specific and strongly, but test period is long, it influences the judgement of the result after usually waiting for effective drug therapy to employ erythromycin A to be very mould; About half the MG agglutinate to test masculine gender is agglutinate to test for diagnose the intersection of pneumonia and traditional method that mycoplasma is infect to streptococcus patient, but its sensitiveness and specificity are unsatisfactory; The complement is combined and tested and does not check so sensitively and peculiarly as other serology, but is generally employed because the method is simple and convenient
3.The antigen is measured and used for diagnosing the commonsense method is as follows, in early days Test the technological Elisa law and clone more antibody disconnected immune fluoro to determine in enzyme immunity of the firm looks, the nuclear acid of immune blot law of monoclonal antibody hybridizes technology and polymerase chain reaction technology,etc., can nasopharyngeal secretion or phlegm measure the intersection of pneumonia and the intersection of mycoplasma and antigen and establish, diagnose fast simple and convenient to accord with clinical requirement their sensitiveness specificity law this in the sample and from patient directly Stability remains to further improve. The nuclear acid hybridizes technology and already makes reagent box, have advantage such as being high-efficient, peculiar and sensitive, easy to popularize.
Employ the fluorogenic method of the immunity to observe and check the mycoplasma under doing the phlegm, swallowing slide very direct mirror of the secretion at present, the method is simple and convenient fast, it is clinical that it has been already extensive that 1- 2h can make diagnosisOther auxiliary examination: The chest X-ray behaves: It is basic that pneumonia in mycoplasma for pathology it show as bronchus and bronchitises detailed and among display to present is there characteristic to the laminations strengthen and along lamination after can lunging to diversification pneumonia chest stretch quality Abnormality, flaky shadow of lower even spot of density that the ones that are distributed occur frequently, more than half is presented leafily and is distributed; It has lower leafs that is given much trouble that nearly half both sides are infringed most cases; Pathological change can limitation around position isolatedly, but door wild to spread and shallow fan-shaped shade gradually to lung from lung mostly; Lung spot one common or position many focus can absorb slow elder nearly 4 week more than about 1/3 patient can present single side brief thorax accumulate liquid.
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