荧光定量PCR在肺炎衣原体感染中的诊断评价  

Diagnostic evaluation of fluorescent quantitative PCR for Chlamydia pneumoniae infection

作　　者：郑广力[1] 孙利炜[1] 李丽红[1] 刘愉[1] 鲁继荣[2] 

机构地区：[1]长春市儿童医院,吉林长春130051 [2]吉林大学第一临床医院,吉林长春130021

出　　处：《临床儿科杂志》2009年第7期619-621,共3页Journal of Clinical Pediatrics

摘　　要：目的探讨肺炎衣原体荧光定量PCR在小儿肺炎衣原体感染中的诊断价值。方法对象为诊断为肺炎,且采用肺炎衣原体荧光定量PCR方法检测其深部呼吸道分泌物中肺炎衣原体DNA呈阳性的患儿(阳性阈值1.0×103copy/ml)248例。分析患儿临床资料,并进行血清学肺炎衣原体特异性抗体(Cpn-IgM)检测,用定量资料受试者工作特征曲线下面积,评价肺炎衣原体荧光定量PCR的诊断价值。结果肺炎衣原体荧光定量PCR诊断方法在受试者工作特征曲线下面积=0.625;Cpn-IgM阳性组的PCR拷贝数[log(Cpn-DNAcopy/ml)]为5.31±1.25,阴性组为4.76±1.27,差异有统计学意义(P<0.05);Cpn-IgM阳性组患病年龄为65(26.2～96.5)个月,阴性组患病年龄为7(2.0～41.5)个月(P<0.001);Cpn-IgM阳性组病程为7(5～13)d,阴性组病程为7(5～10.8)d,两组差异无统计学意义(P>0.05)。结论肺炎衣原体荧光定量PCR单独用于诊断肺炎衣原体感染准确性较低,但是对于免疫系统尚未发育完善的婴幼儿具有一定的诊断价值;且荧光定量PCR的拷贝数越大,越支持肺炎衣原体感染的诊断。Objective To explore the diagnostic value of fluorescent quantitative PCR for Chlamydia pneumoniae （Cpn） infection. Methods Total of 248 children with pneumonia and positive （positive limit value 1.0× 10^3 copy/ml） Cpn-DNA of deep respiratory tract secretion were enrolled into this study. Age, sex, course of the disease and other general clinical data were recorded. All the patients also had results of Cpn-IgM measured by a fluorescent quantitative PCR. Area under the ROC curve （Az） was used as the index to evaluate the diagnostic value of fluorescent quantitative PCR. Results Diagnostic accuracy of fluorescent quantitative PCR for detecting Cpn infection was Az = 0.625. The number of copies of the cases in Cpn- IgM-positive group [log （Cpn-DNA copy/ml）] was 5.31± 1.25 while in Cpn-IgM- negative group it was 4.76 ± 1.27 （P 〈 0.05）. The age of Cpn-IgM positive group was 65 （26.2 - 96.5） months while in Cpn-IgM-negative group it was 7 （2.0 - 41.5） months （P 〈 0.001）. The course of Cpn-IgM positive group was 7 （5 13） d, and that of Cpn-IgM-negative group was 7 （5 - 10.8） d. There was no significant difference between two groups. Conclusions The diagnostic accuracy of fluorescent quantitative PCR for Chlamydia pneumoniae （Cpn） infection is low; however for children whose immunologic systems are not fully developed, this technique has some diagnostic value, and higher number of Cpn-DNA copies may support diagnosis of Cpn infection.

关 键 词：聚合酶链反应 诊断 肺炎衣原体 

分 类 号：R725.6[医药卫生—儿科]