肺炎支原体RNA检测用于肺炎患儿疾病诊断和疗效监测  

Role of Mycoplasma pneumoniae RNA determination in diagnosis and efficacy monitoring of pneumonia in children

作　　者：王慧英[1] 汤昱 董利利[1] 王静[1] WANG Huiying;TANG Yu;DONG Lili;WANG Jing(Department of Respiratory,Zhengzhou Children's Hospital,Henan Children's Hospital,Children's Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China)

机构地区：[1]郑州大学附属儿童医院河南省儿童医院郑州儿童医院东区呼吸科,河南郑州450000

出　　处：《检验医学》2023年第9期865-869,共5页Laboratory Medicine

基　　金：河南省医学科技攻关项目(2018020614)。

摘　　要：目的分析肺炎支原体(MP)RNA检测在儿童MP肺炎诊断和治疗监测中的价值。方法收集2019年5月—2021年1月郑州大学附属儿童医院167例肺炎患儿痰液样本,行MP-RNA、MP-DNA、MP-IgG抗体和MP-IgM抗体检测。分析4项指标诊断儿童MP肺炎的特异性和敏感性。分析患儿MP-RNA、MP-DNA阳性率和治疗1、2、3、4周后转阴情况,以及转阴后患儿临床症状发生率。比较不同MP-RNA转阴时间患儿临床症状持续时间和入院时血清C反应蛋白(CRP)、白细胞介素8(IL-8)和白细胞(WBC)计数差异。结果167例患儿中,经MP培养证实有95例感染MP。MP-RNA、MP-DNA、MP-IgM抗体、MP-IgG抗体诊断儿童MP肺炎的特异性依次降低,MP-RNA、MP-IgM抗体、MP-DNA、MP-IgG抗体诊断儿童MP肺炎的敏感性依次降低。MP-RNA阳性率(r=-0.901,P=0.017)和MP-DNA阳性率(r=-0.601,P=0.031)与治疗时间呈负相关。治疗2、3、4周,患儿MP-RNA阳性率均低于MP-DNA(P<0.0001)。与MP-DNA比较,MP-RNA转阴后,患儿咳嗽发生率更高(P<0.05)。治疗1、2、3、4周MP-RNA转阴患儿发热、咳嗽、喘息、肺啰音持续时间均依次延长(P<0.0001),入院时血清CRP、IL-8、WBC计数均依次升高(P<0.0001)。结论MP-RNA、MP-DNA对儿童MP肺炎均有一定的诊断价值。相较而言,MP-DNA适用于诊断儿童MP肺炎,而MP-RNA更适用于儿童MP肺炎的疗效监测。Objective To analyze the role of Mycoplasma pneumoniae(MP)RNA determination in the diagnosis and efficacy monitoring of pneumonia in children.Methods Totally,167 children with pneumonia in Zhengzhou Children's Hospital from May 2019 to January 2021 were enrolled.Sputum samples were collected for MPRNA,MP-DNA,MP-IgG antibody and MP-IgM antibody determinations.The specificities and sensitivities of MPDNA,MP-RNA,MP-IgM antibody and MP-IgG antibody for diagnosing MP were evaluated.The positive rate of MP-RNA and MP-DNA and the incidence of clinical symptoms after 1,2,3 and 4 weeks of treatment were analyzed.The duration of clinical symptoms and serum C-reactive protein(CRP),interleukin-8(IL-8)and white blood cell(WBC)count of children with different MP-RNA turn-negative time were compared.Results MP culture proved that 95 of 167 children were infected with MP.The specificities for diagnosing MP pneumonia in children were MPRNA>MP-DNA>MP-IgM antibody>MP-IgG antibody.The sensitivities were MP-RNA>MP-IgM antibody>MPDNA>MP-IgG antibody.The positive rates of MP-RNA and MP-DNA were negatively correlated with the duration of treatment(r=-0.901,P=0.017;r=-0.601,P=0.031).For 2,3 and 4 weeks of treatment,the positive rate of MPRNA was lower than that of MP-DNA(P<0.0001).Compared with MP-DNA,the incidence of cough after MP-RNA turn-negative was higher(P<0.05).After 1,2,3 and 4 weeks of treatment,the duration of fever,cough,wheezing and pulmonary rales in MP-RNA turn-negative children were successively prolonged(P<0.0001),and serum CRP,IL-8 and WBC count were successively increased on admission(P<0.0001).Conclusions MP-RNA and MP-DNA have certain diagnostic value in children with MP pneumonia.In contrast,MP-DNA is more suitable for the diagnosis of children with MP,and MP-RNA is suitable for monitoring the efficacy of children with MP.

关 键 词：肺炎支原体 DNA RNA 下呼吸道感染 肺炎 诊断 疗效监测 儿童 

分 类 号：R375[医药卫生—病原生物学]