肺炎支原体RNA-SAT对儿童社区获得性肺炎诊治的价值  

The value of Mycoplasma pneumoniae RNA-SAT in the diagnosis and treatment of community acquired pneumonia in children

作　　者：黄育涛[1] 蔡幸生[1] 朱勇斌[1] HUANG Yutao;CAI Xingsheng;ZHU Yongbin(The People’s Hospital of Jieyang City,Jieyang 522000,China)

机构地区：[1]揭阳市人民医院,揭阳522000

出　　处：《广州医药》2020年第6期94-97,共4页Guangzhou Medical Journal

摘　　要：目的探讨肺炎支原体核糖核酸恒温扩增技术(MP RNA-SAT)对儿童社区获得性肺炎(CAP)诊治的价值。方法选择310例CAP的临床资料进行回顾性分析,其中肺炎支原体肺炎(MPP)和非肺炎支原体肺炎各155例,比较这两组的MP RNA-SAT和MP-IgM的检测结果。结果以临床诊断为标准,RNA-SAT的特异度(97.4%)及阳性预测值(92.2%)高于IgM(分别为72.3%、74.4%),而敏感度(30.3%)及阴性预测值(58.3%)则低于IgM(分别为80.6%、78.9%),差异有统计学意义(P<0.05);年龄>3岁、检测前不使用大环内酯类药物以及选择肺泡灌洗液作为检测标本均能提高RNA-SAT的检出率(P<0.05)。结论RNA-SAT能特异度识别出MP的活动性感染,联合使用RNA-SAT和IgM检测,能更加快速、准确地诊断MP感染,对儿童肺炎的诊治具有较高的价值。尽量在使用大环内酯类药物治疗前进行RNA-SAT检测,必要时可选择肺泡灌洗液作为检测标本以提高检出率。Objective To investigate the value of Mycoplasma pneumoniae RNA simultaneous amplification and testing(MP RNA-SAT)in the diagnosis and treatment of community acquired pneumonia(CAP)in children.Methods The clinical data of 310 children with CAP were selected for retrospective analysis,including 155 Mycoplasma pneumonia pneumonia(MPP)and 155 non-MPP,and the results of MP RNA-SAT and MP-IgM in both groups were compared.Results With the results of clinical diagnosis as reference,the specificity(97.4%)or positive predictive value(92.2%)by RNASAT was higher than that by IgM(72.3%and 74.4%,respectively),while the sensitivity(30.3%)or negative predictive value(58.3%)was lower than that by IgM(80.6%and 78.9%,respectively).The difference was statistically significant(P<0.05).Age>3 years,no macrolide treatment before testing,or choosing bronchoalveolar lavage fluid as testing samples,that can improve the detection rate of RNA-SAT(P<0.05).Conclusion RNA-SAT may specifically identify active infection of MP,and the combined use of RNA-SAT and IgM test may more quickly and accurately diagnose infection of MP.It has high value for the diagnosis and treatment of community acquired pneumonia in children.RNA-SAT should be performed before the application of macrolide treatment as early as possible.If necessary,bronchoalveolar lavage fluid could be chosen as testing samples to improve the detection rate of RNA-SAT.

关 键 词：恒温扩增技术 核糖核酸 肺炎支原体 社区获得性肺炎 儿童 

分 类 号：R725.6[医药卫生—儿科]