肺炎支原体感染4种特异性抗体检测的临床研究  

Determination of four isotype-specific antibodies against Mycoplasma pneumoniae

作　　者：曹兰芳[1] 徐凌云[1] 卢燕鸣[1] 马敏[1] 毛海英[1] 陆伟蓉[1] 

机构地区：[1]上海第二医科大学附属仁济医院儿科,上海200001

出　　处：《中国当代儿科杂志》2005年第2期143-146,共4页Chinese Journal of Contemporary Pediatrics

摘　　要：目的探讨肺炎支原体(MP)特异性IgM,IgA,IgG对肺炎支原体感染诊断价值,及MP-IgE与支气管哮喘发病的关系.方法采用酶联免疫吸附试验对临床高度怀疑肺炎支原体感染患儿测定特异性MP-IgA,IgG,IgE,采用颗粒凝集法测定MP-IgM,并对57例肺炎支原体感染患儿随访2～5.5月.结果在372例肺部感染患儿中,MP-IgA阳性184人,占49.5%;MP-IgM阳性241人,占64.8%;2种抗体同时阳性140人,占37.6%,2种MP特异抗体测定结果的一致性非常显著.其中149例测定了MP-IgG,105例阳性,占70.5%;而30例正常对照组中仅2例MP-IgG阳性,占6.7%,正常对照组MP-IgA,MP-IgM皆为阴性.MP-IgA,MP-IgM,MP-IgG的阳性率,在发病第2周均达到80%以上,明显高于第1周,在随访的57例MP感染患儿中,25例有反复呼吸道感染,MP-IgA在随访时阳性率明显增高,MP-IgM滴度居高不下;而在32例无呼吸道感染患儿中,MP-IgA的阳性率变化不明显,MP-IgM滴度则明显下降.MP感染组的MP-IgE的阳性率达73.3%,与哮喘合并MP感染组接近,但与哮喘合并非MP感染组及正常对照组比较差异有显著性.结论4种特异性肺炎支原体抗体测定对于提高MP感染诊断的特异性、敏感性具有十分重要的临床价值,尤其对于MP再感染的发现及MP感染诱发支气管哮喘的发作机制研究及进一步治疗提供了理论依据.ObjectiveTo study the value of isotype-specific IgM, IgA, IgG and IgE antibodies against Mycoplasma pneumoniae (MP) in the diagnosis of childhood MP infection and the relationship between MP-IgE and asthma attack. Methods Specific MP-IgA, MP-IgE and MP-IgG antibodies were measured by ELISA; and specific MP-IgM, with pellet agglutination assay in children with suspected MP infection. Fifty-seven cases with definitive diagnosis of MP infection were followed up for 2-5.5 months. Thirty healthy age-matched children were used as the controls. Results Of the 372 patients with suspected MP infection, 184 were MP-IgA positive (49.5%), 241 MP-IgM positive (64.8%) and 140 were both MP-IgA and MP-IgM positive. The Chi-squared test showed a significant coincidence between the positive rates of MP-IgA and MP-IgM. MP-IgG positive was found in 105 patients (70.5%) out of 149 cases tested. In the 30 normal controls, only 2 were MP-IgG positive and none, MP-IgA and IgM positive. It was in the second week of the disease course that the positive rates of MP-IgA, MP-IgM and MP-IgG were the highest in 57 patients with definitive diagnosis of MP infection. Recurrent respiratory infection occurs in 25 out of 57 followed-up MP patients. The positive rate of MP-IgA increased significantly in the 25 cases compared the initial positive rate and the titer of MP-IgM also remained high. In the 32 cases without recurrent respiratory infection, the titer of MP-IgM was significantly reduced and the positive rate of MP-IgA did not show differences compared with the initial findings. The positive rate of MP-IgE in patients with MP infection was significantly higher than that in the normal controls and the asthmatic patients without MP infection, but was the same as the asthmatic patients accompanied by MP infection. Conclusions The determination of MP-IgA, IgM, IgG and IgE is of importance in increasing the specificity and sensitivity of the diagnosis of MP infection, and especially in the diagnosis of the repeated MP infection. MP-IgE may

关 键 词：肺炎支原体 肺炎支原体抗体IgM、IgG、IgA、IgE 儿童 

分 类 号：R725.6[医药卫生—儿科]