两种血清支原体抗体检测方法在诊断儿童肺炎支原体肺炎中的价值  

Comparative study on two serological detection methods of mycoplasma pneumoniae in children with mycoplasmal pneumonia

作　　者：刘欣[1,2] 郭沙沙 王冲 朱元旗 王振虹 曲政海 

机构地区：[1] 河北省邢台市第三医院儿科,054400 [2] 青岛大学附属医院儿科,266003

出　　处：《中国医师进修杂志》2017年第3期211-213,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 比较金标免疫斑点法和颗粒凝集法用于临床诊断肺炎支原体（MP）肺炎的敏感度和特异度.方法 对113例MP肺炎患儿的190份血清标本（感染组）和50例健康儿童的50份血清标本（健康组）分别采用金标免疫斑点法A、B和颗粒凝集法进行MP抗体检测.结果 在感染组中,金标免疫斑点法A和B阳性率分别为82.63%（157/190）和84.74%（161/190）,两者比较差异无统计学意义（χ2=0.31,P〉0.05）;颗粒凝集法以滴度≥1：160作为判定标准时阳性率为70.00%（133/190）,明显低于金标免疫斑点法A和B,差异有统计学意义（P〈0.05）.感染组患儿随着颗粒凝集法滴度的升高,金标免疫斑点法的阳性率逐渐升高,两者有相关性（rA=0.972、rB=0.830）;金标免疫斑点法在颗粒凝集法阴性的标本阳性率为40.62%（13/32）和53.12%（17/32）,而且金标免疫斑点法在颗粒凝集法滴度1：5120时仍有阴性结果.健康组中,金标免疫斑点法A和B阳性率分别为26.00%（13/50）和28.00%（14/50）,两种金标免疫斑点法比较差异无统计学意义（χ2=0.66,P〉0.05）;颗粒凝集法阳性率为8.00%（4/50）,明显低于金标免疫斑点法A和B,差异有统计学意义（P〈0.05或〈0.01）.结论 与颗粒凝集法相比,金标免疫斑点法用于临床血清MP抗体的定性诊断时敏感度低、特异度差,不适合临床用于MP现症感染的诊断.Objective To compare the sensitivity and specificity of dot immunogold method （DIM） and particle agglutination （PA） for the diagnosis of mycoplasma pneumoniae （MP） infection. Methods The 190 serum specimens of 113 children with mycoplasmal pneumonia （infection group） and 50 serum specimens of 50 health children （health group） were tested for MP by PA and DIM- A and B. Results In infection group, the positive rates of DIM- A and B were 82.63% （157/190） and 84.74%（161/190）, and there was no statistical difference （χ2 = 0.31, P〉0.05）; the positive rate of PA （titer ≥1：160） was 70.00%（133/190）, the positive rate of PA was significantly lower than that in DIM-A and B, and there were statistical differences （P〈0.05）. In infection group, with the increase of PA titer, the positive rate of DIM was gradually increased, and there was a correlation between 2 methods （rA=0.972, rB=0.830）;the positive rates of DIM- A and B in serum specimens of PA negative were 40.62%（13/32） and 53.12%（17/32）, and in the PA titer of 1：5120, there was still a negative result in DIM. In health group, the positive rates of DIM-A and B were 26.00% （13/50） and 28.00% （14/50）, and there was no statistical difference （χ2 = 0.66, P〉0.05）; the positive of PA was 8.00% （4/50）, the positive rate of PA was significantly lower than that in DIM- A and B, and there were statistical differences （P〈0.05 or〈0.01）. Conclusions Compared with the PA, DIM has low sensitivity and poor specificity for clinical diagnosis. DIM is not suitable for clinical diagnosis of MP infection.

关 键 词：肺炎 支原体 儿童 颗粒凝集法 金标免疫斑点法 

分 类 号：R725.6[医药卫生—儿科]