化学发光免疫分析法检测肺炎支原体抗体在儿童肺炎支原体感染诊断中的价值  

Diagnostic value of chemiluminescence immunoassay for Mycoplasma pneumoniae antibody in children with Mycoplasma pneumoniae infection

作　　者：金海勇[1] 沈观樵[1] 陆亚玲[1] JIN Hai-yong;SHEN Guan-qiao;LU Ya-ling(Laboratory Center,Shaoxing Second Hospital,Shaoxing,Zhejiang 312000,Chiina)

机构地区：[1]绍兴第二医院检验中心,浙江绍兴312000

出　　处：《中国卫生检验杂志》2022年第18期2229-2232,共4页Chinese Journal of Health Laboratory Technology

基　　金：绍兴市柯桥区2020年社会发展类经费自筹科技计划项目(2020KZ61)。

摘　　要：目的探讨化学发光法检测肺炎支原体(Mycoplasma pneumoniae,MP)IgG和IgM抗体在儿童肺炎支原体感染诊断中的价值。方法收集了2019年6月11日—2022年3月9日在绍兴第二医院儿科收治的确诊MP感染患儿66和非MP感染患儿63例的相关资料,采用化学发光免疫分析法(CLIA)方法在患儿发病早期(7 d以内)进行血清肺炎支原体IgG和IgM抗体检测,并在3 d~12 d内再次检测血清肺炎支原体IgG和IgM抗体水平。结果配对血清IgM1.44倍升高作为截断值,敏感度为0.909,特异度为0.937。配对血清IgG 1.66倍升高作为截断值,敏感度为0.833,特异度为0.984。恢复期第2次检测IgM为阳性作为诊断指标,敏感度为0.803,特异度为0.889。恢复期第2次检测IgG为阳性作为诊断指标,敏感度为0.652,特异度为0.825。患儿感染急性期检测IgM抗体和IgG抗体AUC接近0.5,对诊断MP感染无帮助。结论IgM和IgG配对血清升高的比值对MP感染有着较高的诊断价值,且比传统的被动凝集法相比,窗口期明显缩短。恢复期单次血清检测IgM抗体水平对诊断也有一定的价值,恢复期单次血清IgG检测的敏感性较低。急性期单次检测血清IgG和IgM抗体对确诊MP感染诊断无价值。Objective To explore the value of chemiluminescence in the diagnosis of Mycoplasma pneumoniae(MP)infection in children.Methods The data of 66 children with MP infection and 63 children without MP infection treated in pediatrics of Shaoxing Second Hospital from June 11,2019 to March 9,2022 were collected.The serum IgG and IgM antibodies of Mycoplasma pneumoniae were detected by CLIA method in the early stage(within 7 days),and IgG and IgM of Mycoplasma pneumoniae in serum were detected again within 3-12 days.Results When we set 1.44 times that IgM increased among the paired serum as the cut-off value,the sensitivity was 0.909 and the specificity was 0.937.The 1.66 times that IgG increased among the paired serum as the cut-off value,the sensitivity was 0.833 and the specificity was 0.984.Positive IgM for the second time along as a diagnostic index,the sensitivity is 0.803,and the specificity is 0.889.The positive IgG second detected alone as a diagnostic index,the sensitivity is 0.652 and the specificity is 0.825.The AUC of IgM antibody and IgG antibody in the acute stage of infection was close to 0.5,which were not helpful for the diagnosis of MP infection.Conclusion The increased ratio of IgM and IgG in paired serum has high diagnostic value for MP infection,and the window period is significantly shorter than that of traditional PA method.The single serum detection of IgM antibody level in the recovery period also has a certain value for diagnosis,and the sensitivity of single serum IgG detection in the recovery period is low.Single detection of serum IgG and IgM antibodies in acute phase is of no value in the diagnosis of MP infection.

关 键 词：化学发光免疫分析法 肺炎支原体 被动凝集法 截断值 

分 类 号：R725.6[医药卫生—儿科]