磁微粒化学发光法在肺炎感染患者血清免疫标志物检验中的应用价值  

Application value of magnetic particle chemiluminescence assay in the detection of serum immunomarkers in patients with pneumonia infection

作　　者：杨小莹 白薇 黄婷 杨云侠 YANG Xiaoying;BAI Wei;HUANG Ting;YANG Yunxia(Department of Respiratory and Critical Care Medicine,Xi'an Daxing Hospital,Xi'an,Shaanxi 710000,China)

机构地区：[1]西安大兴医院呼吸与危重症医学科,陕西西安710000

出　　处：《检验医学与临床》2024年第3期359-362,367,共5页Laboratory Medicine and Clinic

摘　　要：目的探讨磁微粒化学发光法(CLIA)在肺炎支原体肺炎(MPP)患者血清免疫标志物检验中的应用价值。方法回顾性选取2020年12月值2022年10月在该院就诊的疑似肺炎支原体(MP)感染患者212例为研究对象,根据MP快速培养结果分为MP感染组(112例)和对照组(100例)。采集两组患者空腹静脉血,分别采用CLIA及酶联免疫吸附试验(ELISA)检测免疫球蛋白(Ig)G、IgM、IgA水平,采用受试者工作特征(ROC)曲线评估IgM、IgA、IgG诊断MPP感染的价值。比较CLIA和ELISA检测IgM、IgA、IgG的阳性率,采用四格表法检测CLIA及ELISA诊断MPP感染的准确率、灵敏度及特异度。结果MP感染组血清IgM水平明显高于对照组,IgA、IgG水平明显低于对照组,差异均有统计学意义(P<0.05)。ROC曲线结果显示,IgM、IgA、IgG诊断MPP的曲线下面积(AUC)分别为0.792、0.708、0.733,IgM+IgA+IgG联合诊断MPP的AUC为0.851,明显高于各指标单独诊断的AUC(P<0.05)。采用CLIA检测血清IgM、IgA、IgG的阳性率分别为72.32%、34.82%、31.25%,采用ELISA检测血清IgM、IgA、IgG的阳性率分别为58.93%、20.54%、18.75%,CLIA检测血清IgM、IgA、IgG的阳性率明显高于ELISA检测(P<0.05)。112例MPP阳性患者中,CLIA、ELISA检测阳性率分别为91.07%(102/112)、84.82%(95/112),100例MPP阴性患者中,CLIA、ELISA检测阴性率分别为84.00%(84/100)、74.00%(74/100)。CLIA检测诊断MPP的准确率、灵敏度及特异度分别为87.74%、91.07%、84.00%;ELISA检测诊断MPP的准确率、灵敏度及特异度分别为79.72%、84.82%、74.00%;CLIA检测准确率均高于ELISA检测(P<0.05)。结论MPP感染患者血清IgM、IgA、IgG明显异常表达,三者在诊断MPP方面具有一定价值;CLIA检测IgM、IgA、IgG的阳性表达率较高,可提高诊断MPP的准确性,可作为临床筛查MP感染的检查方式进行推广应用。Objective To analyze the value of magnetic particle chemiluminescence assay(CLIA)in the testing of serum immunomarkers in patients with Mycoplasma pneumoniae pneumonia(MPP).Methods A total of 212 patients with suspected Mycoplasma pneumoniae(MP)infection who were treated in the hospital from December 2020 to October 2022 were retrospectively selected for the study,and they were divided into MP infection group(112 cases)and control group(100 cases)according to the results of MP rapid culture.Fasting venous blood was collected from subjects in both groups,CLIA method and enzyme-linked immunosorbent assay(ELISA)were adopted respectively to detect immunoglobulin(Ig)G,IgM and IgA levels,and the values of IgM,IgA and IgG for the diagnosis of MPP infection were assessed by plotting receiver operating characteristic(ROC)curve.To compare the positive rates of IgM,IgA,and IgG of CLIA and ELISA,the accuracy,sensitivity and specificity of CLIA and ELISA for the diagnosis of MPP infections were detected by the fourfold table method.Results The serum IgM level in the MP infection group was significantly higher than that in the control group,and the levels of IgA and IgG were significantly lower than those in the control group,the differences had statistical significance(P<0.05).The ROC curve showed that the area under the curve(AUC)of IgM,IgA,and IgG for diagnosis of MPP was 0.792,0.708,0.733 respectively,and the AUC of the combined detection of IgM+IgA+IgG for diagnosis of MPP was 0.851,which was higher than that of each indicator alone(P<0.05).The positive rates of serum IgM,IgA,IgG were 72.32%,34.82%,31.25%respectively,by CLIA,and 58.93%,20.54%,18.75% respectively,by ELISA,and the positive rates of serum IgM,IgA,and IgG by CLIA were significantly higher than those by ELISA(P<0.05).The positive rates of CLIA and ELISA were 91.07%(102/112)and 84.82%(95/112)respectively,among 112 patients with positive MPP by gold standard test,while the negative rate of CLIA and ELISA were 84.00%(84/100)and 74.00%(74/100)respectively,among 10

关 键 词：磁微粒化学发光法 肺炎 免疫标志物 价值 

分 类 号：R447[医药卫生—诊断学]