不同咽拭子取样肺炎支原体DNA检测对支原体肺炎诊断价值研究  

Study on the diagnostic value of mycoplasma pneumoniae DNA detection from different throat swabs in children with mycoplasma pneumoniae infection

作　　者：丁彩云[1] 王梦瑾 孙立清[1] DING Caiyun;WANG Mengjin;SUN Liqing(Department of Pediatric Respiratory Medicine,Bengbu First People's Hospital,Bengbu,Anhui 233000,China)

机构地区：[1]蚌埠市第一人民医院(蚌埠市儿童医院)小儿呼吸内科,安徽蚌埠233000

出　　处：《安徽医药》2021年第4期733-736,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨不同咽拭子取样肺炎支原体DNA检测对支原体感染性肺炎病儿诊断价值。方法选择2017年2月至2019年6月在蚌埠市第一人民医院接受治疗的疑似肺炎支原体感染住院病儿174例进行研究。所有病儿入院后均由同一组护士采用常规咽拭子取样与改良咽拭子取样两种咽拭子采集方式对气道分泌物进行采集并行支原体DNA检测。参照诸福棠《实用儿科学》第7版中的诊断标准为金标准,分析两种咽拭子取样方式肺炎支原体DNA检测对支原体感染性肺炎病儿的诊断效能。结果174例病儿中37例(21.26%)经金标准诊断确诊为支原体感染性肺炎。常规咽拭子取样肺炎支原体DNA检测与金标准诊断结果一致性尚可(Kappa=0.526,P<0.001),常规咽拭子取样肺炎支原体DNA检测对支原体感染性肺炎诊断的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为78.38%(29/37)、82.48%(113/137)、81.61%(142/174)、54.72%(29/53)、93.39%(113/121)。改良咽拭子取样肺炎支原体DNA检测与金标准诊断结果一致性良好(Kappa=0.781,P<0.001),改良咽拭子取样肺炎支原体DNA检测对支原体感染性肺炎诊断的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为94.59%(35/37)、91.24%(125/137)、91.95%(160/174)、74.47%(35/47)、98.43%(125/127)。改良咽拭子取样肺炎支原体DNA检测对支原体感染性肺炎诊断效能灵敏度、特异度、准确度、阳性预测值均高于常规咽拭子取样(P<0.05)。结论咽拭子取样肺炎支原体DNA检测对支原体感染性肺炎病儿具有较高的诊断价值,采取改良咽拭子取样可有效提高诊断灵敏度、特异度、准确度、阳性预测值。Objective To explore the diagnostic value of Mycoplasma pneumoniae DNA detection from different throat swabs in children with Mycoplasma pneumoniae infection.Methods One hundred and seventy-four hospitalized children with suspected Mycoplasma pneumoniae infection who were treated at Bengbu First People's Hospital from February 2017 to June 2019 were selected for the study.All patients were admitted to the hospital by the same group of nurses using conventional nasal sampling and modified pharyngeal swab sampling to collect airway secretions and perform mycoplasma DNA testing.According to the gold standard in the 7th edition of Zhu Fuzhen's Practical Pediatrics,the diagnostic efficacy of two kinds of throat swab sampling methods for Mycoplasma pneumoniae DNA detection in children with mycoplasma-infected pneumonia was analyzed.Results Of the 174 patients,37(21.26%)were diagnosed as mycoplasma pneumonia by gold standard diagnosis.Conventional throat swab sampling was consistent with gold standard diagnostic results(Kappa=0.526,P<0.001).The sensitivity,specificity and accuracy of conventional throat swab sampling for detection of mycoplasma pneumonia degree,positive predictive value,and negative predictive value were 78.38%(29/37),82.48%(113/137),81.61%(142/174),54.72%(29/53),and 93.39%(113/121).The improved throat swab samples were consistent with the gold standard diagnosis(Kappa=0.781,P<0.001).The sensitivity,specificity and accuracy of the improved throat swab sampling for detection of mycoplasma pneumonia were detected.The positive predictive value and negative predictive value were 94.59%(35/37),91.24%(125/137),91.95%(160/174),74.47%(35/47),and 98.43%(125/127).The sensitivity,specificity,accuracy and positive predictive value of the diagnostic efficiency of the original swine pneumonia were significantly higher than those of the conventional throat swab(P<0.05).Conclusions The throat swab sampling DNA detection of Mycoplasma pneumoniae has a high diagnostic value for children with mycoplasma-infected pneumonia

关 键 词：肺炎 支原体 痰 咽拭子取样 肺炎支原体DNA检测 乙酰半胱氨酸 免疫球蛋白M 诊断价值 

分 类 号：R725.6[医药卫生—儿科]