胶体金法检测肺炎支原体-IgM联合炎症因子在上呼吸道急性感染患儿诊断中的应用  

Application of colloidal gold method for detecting Mycoplasma pneumoniae-IgM combined with inflammatory factors in diagnosis of acute upper respiratory tract infection in children

作　　者：李健英 林建华 Li Jianying;Lin Jianhua(Department of Clinical Laboratory,Dongguan Fenggang Hospital,Dongguan 523690,Guangdong,China)

机构地区：[1]东莞市凤岗医院检验科,广东东莞523690

出　　处：《实用检验医师杂志》2024年第4期303-306,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的探讨采用胶体金法检测肺炎支原体(MP)-免疫球蛋白M(IgM)联合炎症因子在上呼吸道急性感染患儿诊断中的应用。方法采用回顾性研究方法,选择2022年1月—2023年12月东莞市凤岗医院收治的100例上呼吸道急性感染患儿纳入研究,根据以胶体金法检测的MP-IgM是否为阳性分为MP阳性组(50例)与MP阴性组(50例)。比较两组患儿的临床资料〔发热时间、住院时间、合并肺外症状比例、白细胞计数(WBC)、中性粒细胞比例(NEU%)、淋巴细胞比例(LYM%)、丙氨酸转氨酶(ALT)、碱性磷酸酶(ALP)〕。采用酶联免疫吸附试验(ELISA)检测降钙素原(PCT)、超敏C-反应蛋白(hs-CRP),比较两组上述指标水平差异。采用二元Logistic回归方程分析PCT、hs-CRP与MP阳性的相关性;绘制受试者工作特征曲线(ROC曲线)并计算ROC曲线下面积(AUC),分析PCT和hs-CRP对上呼吸道急性MP感染的预测价值。结果MP阳性组的发热时间、住院时间、合并肺外症状比例以及WBC、NEU%水平均显著高于MP阴性组,LYM%水平显著低于MP阴性组,差异均有统计学意义〔发热时间(d):7.25±1.21比5.82±1.07;住院时间(d):12.55±2.26比8.13±1.76;合并肺外症状比例:46.00%比20.00%;WBC(×10^(9)/L):10.58±1.87比8.94±1.62;NEU%:(74.39±6.78)%比(62.21±6.01)%;LYM%:(26.48±5.34)%比(40.81±6.15)%;均P<0.05〕。MP阳性组的血清hs-CRP、PCT水平均显著高于MP阴性组〔hs-CRP(mg/L):15.75±2.18比13.15±2.06;PCT(ng/L):9.75±1.83比6.99±1.64;均P<0.05〕。血清hs-CRP、PCT均与MP感染呈正相关〔优势比(OR)分别为3.197、5.224,95%可信区间(95%CI)分别为1.197~8.533、2.030~13.433,均P<0.05〕。ROC曲线分析结果显示,hs-CRP、PCT的AUC分别为0.856、0.867,95%CI分别为0.782~0.931、0.797~0.937。结论MP阳性上呼吸道急性感染患儿的PCT、hs-CRP水平均显著升高,提示上述指标与MP感染有一定相关性,可作为临床观测指标。Objective To explore the application of colloidal gold method for detecting Mycoplasma pneumoniae(MP)-immunoglobulin M(IgM)combined with inflammatory factors in the diagnosis of acute upper respiratory tract infection in children.Methods Using retrospective research method,the 100 children with acute upper respiratory tract infection admitted to Dongguan Fenggang Hospital from January,2022 to December,2023 were selected for the study.According to whether MP-IgM detected by colloidal gold method was positive,the children were divided into MP positive group(50 cases)and MP negative group(50 cases).The clinical data[duration of fever,length of hospital stay,proportion of concurrent extrapulmonary symptoms,white blood cell count(WBC),neutrophil proportion(NEU%),lymphocyte proportion(LYM%),alanine aminotransferase(ALT)and alkaline phosphatase(ALP)]between two groups of children were compared.Enzyme linked immunosorbent assay(ELISA)was used to detect procalcitonin(PCT)and hypersensitive C-reactive protein(hs-CRP),and the differences in levels of above indicators between the two groups were compared.Using binary Logistic regression equation the correlation between PCT,hs-CRP and MP positivity was analyzed.The receiver operator characteristic curve(ROC curve)was drawn and the area under ROC curve(AUC)was calculated to analyze the predictive value of PCT and hs-CRP for acute upper respiratory tract MP infection.Results The levels of fever time,hospitalization time,proportion of concurrent extrapulmonary symptoms,WBC and NEU%in MP positive group were higher than those in MP negative group,and the level of LYM%was lower than that in MP negative group,with statistically significant differences[fever time(days):7.25±1.21 vs.5.82±1.07;hospitalization time(days):12.55±2.26 vs.8.13±1.76;proportion of concurrent extrapulmonary symptoms:46.00%vs.20.00%;WBC(×10^(9)/L):10.58±1.87 vs.8.94±1.62;NEU%:(74.39±6.78)%vs.(62.21±6.01)%;LYM%:(26.48±5.34)%vs.(40.81±6.15)%;all P<0.05].The serum levels of hs-CRP and PCT in MP positive

关 键 词：上呼吸道急性感染 胶体金法 生化检测 降钙素原 超敏C-反应蛋白 

分 类 号：R72[医药卫生—儿科]