动态监测MP-SAT对成人肺炎支原体肺炎患者临床疗效的预测价值  

Predictive value of dynamic monitoring MP-SAT in clinical curative effect of adult patients with mycoplasma pneumoniae pneumonia

作　　者：牛春密 尹小波[1] 林桦[2] 徐淑凤[1] 赵靖[1] 刘菲菲[1] 罗坤[1] 王晓杰[1] NIU Chun-mi;YIN Xiao-bo;LIN Hua;XU Shu-feng;ZHAO Jing;LIU Fei-fei;LUO Kun;WANG Xiao-jie(Depatrment of Respiratory and Critical Care Medicine,First Hospital of Qinhuangdao,Qinhuangdao 066000;Third Department of Geriatrics,Hebei General Hospital,Shijiazhuang 050000,Hebei,China)

机构地区：[1]秦皇岛市第一医院呼吸与危重症医学科,河北秦皇岛066000 [2]河北省人民医院老年病三科,河北石家庄050000

出　　处：《川北医学院学报》2022年第1期84-87,共4页Journal of North Sichuan Medical College

基　　金：河北省秦皇岛市科学技术研究与发展计划项目(201703A066)。

摘　　要：目的:探讨动态监测肺炎支原体RNA实时荧光恒温扩增技术(MP-SAT)对成人肺炎支原体肺炎(MPP)患者临床疗效的预测价值。方法:选取78例成人MPP患者为研究对象,入院24 h内咽拭子MP-SAT检测均阳性,采用喹诺酮类抗生素常规方案治疗。患者入院24 h内与治疗后每7 d(连续4周)检测血清MP-Ab、咽拭子MP-SAT及血常规[白细胞(WBC)、中性粒细胞百分率(N)、淋巴细胞百分率(L)]、超敏C反应蛋白(CRP)、血清乳酸脱氢酶(LDH)。统计患者MP-SAT转阴时间、临床痊愈时间、发热、咳嗽、喘息、肺部啰音等临床症状持续时间;分析MP-SAT转阴时间与临床痊愈时间的相关性。结果:患者MP-Ab阳性率随治疗时间延长而逐渐增高,MP-SAT阳性率随治疗时间延长而逐渐降低。除WBC外,与转阴前比较,MP-SAT转阴后患者发热、咳嗽、喘息、肺部啰音例数减少(P<0.05),N、CRP、LDH水平降低(P<0.05),L水平升高(P<0.05)。MP-SAT转阴时间越长,发热、咳嗽、喘息、肺部啰音等临床症状持续时间越长,入院24 h内N、CRP、LDH水平越高,L水平越低,各时间点比较,差异均有统计学意义(P<0.05)。相关性分析显示,MP-SAT转阴时间与临床痊愈时间正相关(r=0.214,P=0.031)。结论:MP-SAT与MPP患者临床症状及炎症反应的相关性较好,动态监测MP-SAT可预测喹诺酮类抗生素治疗MPP患者的临床疗效。Objective:To analyze predictive value of dynamic monitoring mycoplasma pneumoniae(MP) RNA simultaneous amplification and testing for MP(MP-SAT) in clinical curative effect of adult patients with mycoplasma pneumoniae pneumonia(MPP).Methods:78 adult patients with MPP were selected as the research object.The MP-SAT test of pharyngeal swabs was positive within 24 h after admission.They were treated with quinolone antibiotics.Serum MP-Ab,pharyngeal swab MP-SAT and blood routine [white blood cells(WBC),neutrophil percentage(N),lymphocyte percentage(L)],high-sensitivity C-reactive protein(CRP),and serum lactate dehydrogenase(LDH) were measured within 24 hours after admission and every 7 days(4 weeks).The time of MP-SAT turning negative,the time of clinical recovery,the duration of clinical symptoms such as fever,cough,wheezing and pulmonary rales were counted.The correlation between MP-SAT negative conversion time and clinical recovery time was analyzed.Results:The positive rate of MP-Ab was gradually increased with prolongation of treatment time,while positive rate of MP-SAT was gradually decreased.Except WBC,compared with those before negative conversion,clinical symptoms and laboratory indexes were significantly improved in patients after negative conversion of MP-SAT,number of cases with fever,cough,wheezing and lung rale was significantly reduced,levels of N,CRP and LDH were significantly decreased,and L level was significantly increased(P<0.05).The longer the negative conversion time of MP-SAT,the longer the duration of clinical symptoms such as fever,cough,wheezing,and lung rale,the higher the levels of N,CRP and LDH within 24 h after admission,the lower the L level,the differences were statistically significant at each time point(P<0.05).The results of Pearson correlation analysis showed that negative conversion time of MP-SAT was positively correlated with clinical cure time(r=0.214,P=0.031).Conclusion:MP-SAT is well correlated with clinical symptoms and inflammatory response in MPP patients.Dynamic monitoring

关 键 词：肺炎 肺炎支原体 RNA实时荧光恒温扩增技术 临床疗效 预测价值 

分 类 号：R563.1[医药卫生—呼吸系统]