SAT在儿童肺炎支原体肺炎疗效评估中的应用价值  

Value of simultaneous amplification and testing in effect assessment of children with Mycoplasma pneumoniae pneumonia

作　　者：陈丹[1] 孙晓敏[1] 任彦红[1] 张广超 郭青[1] 赵红丽[1] CHEN Dan;SUN Xiao-min;REN Yan-hong;ZHANG Guang-chao;GUO Qing;ZHAO Hong-li(Department of Respiratory Medicine,Children s Hospital Affiliated to Zhengzhou University/Henan Provincial Children s Hospital/Zhengzhou Children s Hospital,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学附属儿童医院/河南省儿童医院/郑州儿童医院呼吸科

出　　处：《临床肺科杂志》2019年第9期1606-1609,共4页Journal of Clinical Pulmonary Medicine

基　　金：河南省医学科技攻关项目计划(联合共建项目)(No 2018020632)

摘　　要：目的评估实时荧光核酸恒温扩增检测技术(SAT)在儿童肺炎支原体肺炎治疗效果评估中的应用价值。方法随机选取2016年09月至2018年05月住院的肺炎支原体肺炎且入院时MP-SAT阳性的患儿104例,行阿奇霉素治疗,动态监测MP-SAT。比较:1.MP-SAT转阴前后临床征象及炎症指标的恢复情况;2.不同MP-SAT转阴时间患儿的临床征象恢复情况及入院时的炎症指标;3.MP-SAT转阴时间与临床治愈时间。结果随着治疗时间的延长,MP-SAT的阳性率逐渐减低;MP-SAT转阴后患儿的发热、咳嗽、喘息、肺部啰音、WBC、CRP、LDH、IL-6较MP-SAT转阴前明显改善(P均<0.05);MP-SAT转阴时间与患儿发热、咳嗽、喘息、肺部啰音恢复时间呈正相关(r分别为0.623、0.477、0.568、0.515);MP-SAT转阴时间越长,患儿入院时的WBC、CRP、LDH、IL-6的值越高(P均<0.05);MP-SAT转阴时间与临床痊愈时间呈正相关(r=0.699,P=0.028)。结论MP-SAT与肺炎支原体临床征象及炎症指标的恢复情况相关性好,可作为评估肺炎支原体肺炎疗效及辅助判愈的指标,帮助临床准确判断患者发病状态和确定方案,减少过度治疗引起的抗生素滥用。Objective To investigate the value of simultaneous amplification and testing(SAT)in assessment of treatment effect of children with Mycoplasma pneumoniae pneumonia(MPP).Methods 104 children with Mycoplasma pneumoniaepneumonia and MP-SAT positive who were hospitalized from September 2016 to May 2018 were enrolled and treated with azithromycin.MP-SAT was dynamically monitored.The recovery of clinical signs and inflammatory indicators were compared before and after MP-SAT vaginal discharge,the recovery of clinical signs and the inflammatory index at admission of children with different MP-SAT negative time were compared,and MP-SAT negative time with clinical cure time were compare as well.Results With the prolongation of treatment time,the positive rate of MP-SAT decreased gradually.The fever,cough,wheezing,lung voice,WBC,CRP,LDH and IL-6 of children with MP-SAT after negative conversion showed significant improvement before vaginal discharge(P<0.05).The time of MP-SAT positive was positively correlated with fever,cough,wheezing,and lung arpeggio recovery time(r=0.623,0.477,0.568,0.515,respectively).The longer the negative transition of MP-SAT was,the higher the values of WBC,CRP,LDH and IL-6 were(P<0.05).The time of MP-SAT positive was positively correlated with clinical recovery time(r=0.699,P=0.028).Conclusion MP-SAT has a good correlation with the clinical signs of Mycoplasma pneumoniae and the recovery of inflammatory markers.It can be used as an indicator to evaluate the efficacy and assisted recovery of Mycoplasma pneumoniae pneumonia.It can help to accurately determine the morbidity and determination of patients and reduce the antibiotics abuse caused by over-treatment.

关 键 词：肺炎支原体 实时扩增检测 儿童 疗效 

分 类 号：R72[医药卫生—儿科]