儿童肺炎支原体感染核酸与四种血清学抗体检测方法比较  

Comparison of Nucleic Acid and Four Serological Antibody Detection Methods for Mycoplasma Pneumoniae Infection in Children

作　　者：宋波 王玲玲 丰新倩 刘丙金 李庆 SONG Bo;WANG Ling-ling;FENG Xin-qian;LIU Bing-jin;LI Qing(Department of Laboratory,Zibo First Hospital,Zibo 255200,Shandong,China;Department of Pediatrics,Zibo First Hospital,Zibo 255200,Shandong,China)

机构地区：[1]淄博市第一医院检验科,山东淄博255200 [2]淄博市第一医院儿科,山东淄博255200

出　　处：《医学信息》2024年第18期166-169,共4页Journal of Medical Information

基　　金：山东省医药卫生科技发展计划项目(编号:2018WS008);淄博市医药卫生科研项目(编号:20231800130)。

摘　　要：目的比较核酸及四种血清学抗体检测方法在肺炎支原体感染诊断中的应用价值。方法收集淄博市第一医院2021年11月10日-12月22日收治的呼吸道感染患儿159例,分别采集咽拭子和血清样本,咽拭子样本应用PCR法检测肺炎支原体核酸,血清样本分别用磁微粒化学发光法、酶联免疫法、间接免疫荧光法和被动凝集法检测肺炎支原体IgM抗体。比较5种检测方法的灵敏度、特异度以及与临床诊断方法的一致性,分析核酸法与血清学方法的一致性,另通过颗粒凝集方法比较4种血清学抗体检测的一致性。最后,比较不同病程间5种检测方法的检出率。结果以临床诊断为标准,确诊MP感染127例,非MP感染32例。DNA检测与临床诊断一致性较好。4种血清学方法中CLIA灵敏度及特异性均高于ELISA;IFA检测灵敏度较好,但特异性较差;PA灵敏度和特异性取决于判断标准,其中PA抗体滴度≥1∶160为判断标准时,其检测灵敏度最低,特异性最高。4种血清学检测与DNA检测的一致性较差,其中FA与DNA检测的一致性处于微弱程度,其余3种方法学与DNA检测的一致性处于弱程度。不同滴度的PA阳性标本中,随着PA抗体滴度升高,ELISA和CLIA检出率逐步升高,与PA相关性较好,但PA与IFA相关性较差。DNA检出率随发病天数增多呈下降趋势,血清学检出率随发病天数增多呈先升后降趋势。结论核酸法检测肺炎支原体的灵敏度和特异性高,病程早期其灵敏度优于血清学检测,而在病程中后期间免疫荧光法优于核酸法,两种方法学可相互补充。Objective To compare the application value of nucleic acid and four serological antibody detection methods in the diagnosis of Mycoplasma pneumoniae infection.Methods A total of 159 children with respiratory tract infection admitted to Zibo First Hospital from November 10 to December 22,2021 were collected.Throat swabs and serum samples were collected respectively.Throat swab samples were detected by PCR for Mycoplasma pneumoniae nucleic acid.Serum samples were detected by chemiluminescence immunoassay method,enzyme-linked immunosorbent assay,indirect immunofluorescence method and passive agglutination method for Mycoplasma pneumoniae IgM antibody.The sensitivity,specificity and consistency with clinical diagnostic methods of the five detection methods were compared.The consistency between nucleic acid method and serological method was analyzed.The consistency of the four serological antibody detections was compared by particle agglutination method.Finally,the detection rates of the five detection methods were compared among different course of disease.Results With clinical diagnosis as the standard,127 cases of MP infection and 32 cases of non-MP infection were diagnosed.The consistency between DNA detection and clinical diagnosis was good.The sensitivity and specificity of CLIA were higher than those of ELISA.The sensitivity of IFA was good,but the specificity was poor.The sensitivity and specificity of PA depended on the criteria.When the titer of PA antibody≥1∶160 was the criterion,the detection sensitivity was the lowest and the specificity was the highest.The consistency between the four serological tests and DNA detection was poor,among which the consistency between FA and DNA detection was weak,and the consistency between the other three methods and DNA detection was weak.In PA positive samples with different titers,the detection rates of ELISA and CLIA gradually increased with the increase of PA antibody titers,and the correlation with PA was good,but the correlation between PA and IFA was poor.The d

关 键 词：肺炎支原体 核酸法 磁微粒化学发光法 酶联免疫法 间接免疫荧光法 被动凝集法 

分 类 号：R725.6[医药卫生—儿科]