儿科肺炎支原体抗体检测方法比较及不同检测指标临床价值分析  

Comparison of mycoplasma pneumoniae antibody detection methods and discussion of clinical value of laboratory indexes in pediatrics

作　　者：吴李萍[1] 卢旭 卿克勤[1] 李红霞 Wu Liping;Lu Xu;Qing Keqin;Li Hongxia(Department of Medical Laboratory,Chengdu First People's Hospital,Sichuan 610041,China)

机构地区：[1]四川省成都市第一人民医院检验科,610041

出　　处：《实用医技杂志》2020年第5期565-568,共4页Journal of Practical Medical Techniques

摘　　要：目的了解本院儿科患者肺炎支原体感染特点及流行趋势,探讨间接免疫荧光法(IFA)和被动凝集法(PA)在肺炎支原体抗体检测中的临床意义,以及相关炎性指标在肺炎支原体感染早期诊断的临床价值。方法收集本院2018年1月至12月期间儿科患者肺炎支原体抗体检测结果及患者年龄、性别、就诊时间及类型等相关数据,分析支原体肺炎(MP)抗体阳性检出率在不同季节、就诊类型、各年龄段的特点及变化趋势,比较IFA和PA检测MP抗体的一致性,比较MP抗体阳性与阴性患者白细胞、C反应蛋白(CRP)、降钙素原(PCT)和白细胞介素(IL)-6结果有无差异。结果患者PA法检测MP抗体阳性检出率为30.56%,IFA法为7.92%。MP抗体阳性检出率冬季最高,门诊MP抗体阳性检出率高于住院。住院患者中,同日送检IFA法和PA法检测患者共3 686例,IFA法检测MP抗体阳性检出率随年龄增长呈上升趋势,PA法检测MP抗体阳性检出率随年龄增长呈明显增加后略降低趋势,以4~6岁患儿阳性检出率最高。PA法检测不同滴度水平MP阳性检出率均高于IFA法(χ2=47.38,P<0.05)。2种方法检测一致性较差(Kappa=0.05)。MP抗体阳性组白细胞、CRP、IL-6和PCT均值均高于阴性组,其中2组CRP和IL-6差异具有统计学意义(P<0.05);而白细胞和PCT差异无统计学意义(P>0.05)。结论对于流行周期地区,在易感季节各级医院应加强6岁以下幼儿MP感染的筛查。针对高危人群可根据主诉和病程选择阳性和阴性鉴别指标联合检测,以提高MP抗体阳性检出率,并与其他类型病原体感染相鉴别。Objective To analyze the characteristics and epidemic trend of mycoplasma pneumoniae(MP infection in pediatric patients in our hospital,and to explore the significance of indirect immunofluorescence assay and passive agglutination assay methods in detection of MP antibody,and to reveal the value of inflammatory indicators in early diagnosis of MP infection. Methods To collect the results of MP antibody detection and the age,sex,date and type of consultation of patients in pediatric from January to December 2018. The characteristics and trends of MP antibody positive detection rate in different seasons,types of visits,age groups were analyzed. The MP antibody positive detection rate in IFA and PA was compared and the consistency of two methods was calculated. The results of WBC,CRP,PCT and IL-6 of MP positive and negative groups were compared. Results The positive rate of MP antibody detected by PA and IFA was 30.56% and 7.92% respectively. The positive rate of MP antibody was the highest in winter. The positive rate of MP antibody in outpatients was higher than that in inpatients. In the same day,MP antibody of 3 686 patients were examined by IFA and PA. The positive detection rate of MP antibody by IFA increased with age. The positive detection rate of MP antibody by PA increased at first and then decreased slightly with age. The highest positive detection rate was found in children aged 4-6 years. The positive rate of MP detected by PA was higher than that by IFA (χ2=47.38,P<0.05). The consistency of the two methods was poor(Kappa=0.05). The mean values of WBC,CRP,IL-6 and PCT in MP antibody positive group were higher than those in negative group,and the difference of CRP and IL-6 between the two groups was statistically significant(P <0.05),while the difference of WBC and PCT between the two groups was not statistically significant(P >0.05). Conclusion In epidemic cycle areas,hospitals at all levels should strengthen the screening of MP infection in children under 6 years old in susceptible season. For high-r

关 键 词：肺炎支原体 荧光抗体技术 凝集反应 

分 类 号：R725.6[医药卫生—儿科]