儿童社区获得性肺炎血清免疫学病毒特异性抗体检测与呼吸道病毒核酸检测结果一致性分析  

Consistency analysis of serum viral specific antibody against respiratory viruses and nucleic acid determination tests in children with community acquired pneumonia

作　　者：冯黔玉 杨丽娟 赵宏伟 朱云 谢正德 许黎黎 Feng Qianyu;Yang Lijuan;Zhao Hongwei;Zhu Yun;Xie Zhengde;Xu Lili(Beijing Key Laboratory of Pediatric Respiratory Infectious Diseases,Key Laboratory of Major Diseases in Children,Ministry of Education,National Clinical Research Center for Respiratory Diseases,Research Unit of Critical Infection in Children,Chinese Academy of Medical Sciences,Laboratory of Infection and Virology,Beijing Pediatric Research Institute,Beijing Children’s Hospital,Capital Medical University,National Center for Children’s Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心首都医科大学附属北京儿童医院北京市儿科研究所感染与病毒研究室中国医学科学院儿童危重感染诊治创新单元国家呼吸系统疾病临床医学研究中心教育部儿科重大疾病研究重点实验室儿童呼吸道感染性疾病研究北京市重点实验室,北京100045

出　　处：《中华实验和临床病毒学杂志》2022年第2期150-154,共5页Chinese Journal of Experimental and Clinical Virology

基　　金：中国医学科学院儿童危重感染诊治创新单元(2019-I2M-5-026);国家自然科学基金(82172275)。

摘　　要：目的探讨儿童社区获得性肺炎的病毒血清特异性抗体检测与呼吸道病毒核酸检测结果的一致性,以指导其临床应用。方法109例经鼻咽拭子标本实时荧光定量PCR检测诊断为病毒感染的社区获得性肺炎患儿,采集其急性期和恢复期血清标本,采用间接免疫荧光法检测呼吸道常见病毒(呼吸道合胞病毒、腺病毒、甲型流感病毒、乙型流感病毒和副流感病毒)特异性IgM抗体,比较病毒血清特异性抗体检测与呼吸道病毒核酸检测结果的一致性。结果109例呼吸道病毒核酸检测阳性的社区获得性肺炎患儿中,共14例对应病毒急性期血清特异性IgM阳性,占12.8%;综合急性期和恢复期血清病毒特异性抗体检测结果,17例对应病毒血清特异性IgM抗体阳性,占15.6%。一致性分析显示呼吸道合胞病毒、腺病毒、甲型流感病毒、乙型流感病毒和副流感病毒急性期血清特异性IgM抗体检查结果和呼吸道标本核酸检测结果相比,Kappa值分别为-0.033、-0.003、0.053、-0.024、-0.053;综合急性期和恢复期血清病毒特异性抗体检测结果,呼吸道合胞病毒、腺病毒、甲型流感病毒、乙型流感病毒和副流感病毒总的血清特异性IgM检查结果和呼吸道标本核酸检测结果相比,Kappa值分别为0.040、-0.053、0.065、-0.030、-0.018,Kappa值均小于0.4,说明两种方法的检测结果一致性差。结论儿童社区获得性肺炎患者血清免疫学病毒特异性IgM抗体检测与呼吸道标本病毒核酸检测结果的一致性差,提示血清免疫学病毒特异性抗体检测不适宜儿童社区获得性肺炎的病毒病原诊断。Objective To investigate the consistency between the results of serum specific antibodies to respiratory viruses and the nucleic acid tests in children with community acquired pneumonia,and to guide clinical application of these tests.Methods Data of 109 cases of children with community acquired pneumonia diagnosed as viral infection by real-time fluorescence quantitative PCR from nasopharyngeal swab specimens were collected.Their acute and convalescent serum specimens were collected and used to detect common respiratory viruses(respiratory syncytial virus,adenovirus,influenza A virus,influenza B virus and parainfluenza virus)specific IgM antibodies by indirect immunofluorescence method.The consistency between the results of virus serum specific antibody test and respiratory virus nucleic acid test was analyzed.Results Among the 109 cases of community-acquired pneumonia patients with positive respiratory virus nucleic acid test,14 cases(12.8%)were positive for virus specific IgM in the acute stage.Combining the results of serum virus specific antibody detection in the acute and convalescent phases,17 cases(15.6%)were positive for virus specific IgM antibody.Consistency analysis showed that the acute phase serum specific IgM antibody test results of respiratory syncytial virus,adenovirus,influenza A virus,influenza B virus and parainfluenza virus were compared with the nucleic acid test results of respiratory specimens,and Kappa values were-0.033,-0.003,0.053,-0.024,-0.053,respectively.Compared with the nucleic acid test results of respiratory tract specimens and the total serum specific IgM test results of respiratory syncytial virus,adenovirus,influenza A virus,influenza B virus and parainfluenza virus in the acute and convalescence stages,Kappa values were 0.040,-0.053,0.065,-0.030 and-0.018,respectively.Kappa values were all less than 0.4,indicating that the consistency of detection results of the two methods is poor.Conclusions The results of serum virus specific IgM antibody detection in children with commun

关 键 词：儿童社区获得性肺炎 呼吸道病毒 核酸检测 血清特异性抗体检测 

分 类 号：R725.6[医药卫生—儿科]