支气管肺泡灌洗液荧光定量PCR对儿童肺炎支原体肺炎诊断研究  

Value of fluorescence quantitative PCR assay of bronchoalveolar lavage fluid samples in the diagnosis of Mycoplasma pneumoniae pneumonia in children

作　　者：钟礼立[1] 彭力[1] 黄寒[1] 梁沫[1] 周琼华[1] 张兵[1] 李云[1] 

机构地区：[1]湖南省人民医院儿科,湖南长沙410005

出　　处：《中国当代儿科杂志》2011年第3期191-194,共4页Chinese Journal of Contemporary Pediatrics

摘　　要：目的探讨荧光实时定量PCR(FQ-PCR)检测肺泡灌洗液(BALF)中MP-DNA基因在肺炎支原体肺炎(MPP)早期病原诊断中的价值。方法采用FQ-PCR检测61例患儿BALF中MP-DNA,并与目前常用血清MP抗体检测方法颗粒凝集法进行比较。结果 FQ-PCR检测MP-DNA敏感度94%,特异度100%;病程早期及难治性病例中FQ-PCR检测BALF中MP-DNA准确性优于单份血清MP抗体检测(P<0.01)。难治性病例中MP-DNA拷贝数显著高于普通MPP组(P<0.05),且与CRP呈正相关(r=0.845,P<0.01)。结论 FQ-PCR检测BALF中MP-DNA是早期MPP特别是难治性MPP病原诊断的可靠方法,优于血清MP抗体检测。MP-DNA的拷贝量可以作为评价难治性MPP的转归以及判断药物疗效的指标。Objective To study the value of fluorescence quantitative polymerase chain reaction（FQ-PCR） for detecting Mycoplasma pneumoniae（MP）-DNA in bronchoalveolar lavage fluid（BALF） in the early diagnosis of Mycoplasma pneumoniae pneumonia（MPP）. Methods FQ-PCR was used to detect MP-DNA in BALF obtained by fiberoptic bronchoscopy from 61 children with MPP,and the sensitivity and the specificity of FQ-PCR were compared with the traditional serological test. Results The sensitivity and the specificity of BALF FQ-PCR for detecting MP-DNA were 94% and 100% respectively.The accuracy of BALF FQ-PCR assay for detecting MP-DNA was higher than that of the serological test at the early stage of the disease（1-7 days）（P〈0.01）.In the children with refractory MPP,BALF FQ-PCR assay also showed higher accuracy for detecting MP-DNA than the serological test（P〈0.01）.The copies of MP-DNA in children with refractory MPP were significant higher than those in children with common MPP（P〈0.05）.The copies of MP-DNA were positively correlated with CRP values（r=0.845,P〈0.01）. Conclusions FQ-PCR assay of BALF for detecting MP-DNA in BALF is superior to the serological test.It is a reliable method for the early diagnosis of MPP,especially refractory MPP.The copies of MP-DNA can be used as an index for evaluation of the treatment outcome of refractory MPP.

关 键 词：肺炎支原体肺炎 支气管肺泡灌洗液 荧光实时定量PCR 儿童 

分 类 号：R725.6[医药卫生—儿科]