多重实时荧光定量聚合酶链反应对儿童社区获得性肺炎病原学的诊断价值  

Diagnostic value of multiplex real-time fluorescence quantitative polymerase chain reaction for the etiology of community-acquired pneumonia in children

作　　者：李卫[1] 柯买春 杨燕萍[1] LI Wei;KE Maichun;YANG Yanping(Department of Clinical Laboratory,Jiujiang Maternal and Child Health Hospital,Jiujiang,Jiangxi 332000,China)

机构地区：[1]江西省九江市妇幼保健院检验科,江西九江332000

出　　处：《检验医学与临床》2025年第5期635-639,共5页Laboratory Medicine and Clinic

基　　金：江西省九江市科技计划项目(S2023ZDYFN493)。

摘　　要：目的探讨多重实时荧光定量聚合酶链反应(qPCR)对儿童社区获得性肺炎(CAP)病原学的诊断价值。方法选取2024年1-6月来该院就诊的120例CAP患儿作为研究对象,收集所有研究对象一般资料,并采集痰标本、血清标本、咽拭子标本、肺泡灌洗液标本,分别进行痰培养、免疫荧光、单重PCR、多重qPCR检测,比较不同检测方法病原学检测结果的差异。结果痰培养检测CAP患儿细菌阳性率为17.50%(21/120);免疫荧光检测CAP患儿肺炎支原体阳性率为55.83%(67/120),肺炎衣原体阳性率为7.50%(9/120);单重PCR检测CAP患儿细菌阳性率为30.83%(37/120),肺炎支原体阳性率为64.17%(77/120),肺炎衣原体阳性率为10.83%(13/120);多重qPCR检测CAP患儿细菌阳性率为36.67%(44/120),肺炎支原体阳性率为65.83%(79/120),肺炎衣原体阳性率为10.83%(13/120)。多重qPCR检测CAP患儿细菌阳性率高于痰培养,差异有统计学意义(P<0.05);多重qPCR检测与免疫荧光检测CAP患儿肺炎支原体和肺炎衣原体阳性率比较,差异均无统计学意义(P>0.05);多重qPCR检测与单重PCR检测CAP患儿细菌、肺炎支原体和肺炎衣原体阳性率比较,差异均无统计学意义(P>0.05)。多重qPCR检测与痰培养、免疫荧光、单重PCR检测阳性率均一致性良好(Kappa值>0.400,P<0.05)。结论多重qPCR对儿童CAP病原学诊断有积极意义,有较高的阳性率,有助于指导临床医生合理用药,且较单重PCR有更高的检测效率,有利于缩短临床诊疗流程。Objective To investigate the diagnostic value of multiplex real-time quantitative polymerase chain reaction(qPCR)for the etiology of community-acquired pneumonia(CAP)in children.Methods A total of 120 children with CAP who visited the hospital from January to June 2024 were selected as the research objects.The general data of all the research objects were collected,and sputum specimens,serological specimens,throat swab specimens,and bronchoalveolar lavage fluid samples were collected.Sputum culture,immunofluorescence,single PCR and multiple qPCR detection were performed respectively.Results The positive rate of sputum culture in children with CAP was 17.50%(21/120).The positive rate of Mycoplasma pneumoniae and Chlamydia pneumoniae in children with CAP was 55.83%(67/120)and 7.50%(9/120)respectively.The positive rate of bacteria detected by single PCR in children with CAP was 30.83%(37/120),the positive rate of Mycoplasma pneumoniae was 64.17%(77/120),and the positive rate of Chlamydia pneumoniae was 10.83%(13/120).The positive rate of bacteria detected by multiplex qPCR was 36.67%(44/120),the positive rate of Mycoplasma pneumoniae was 65.83%(79/120),and the positive rate of Chlamydia pneumoniae was 10.83%(13/120).The positive rate of bacteria detected by multiplex qPCR in children with CAP was higher than that by sputum culture,and the difference was statistically significant(P<0.05).There was no significant difference in the positive rate of Mycoplasma pneumoniae and Chlamydia pneumoniae between multiple qPCR and immunofluorescence detection in children with CAP(P>0.05).There was no significant difference in the positive rate of bacteria,Mycoplasma pneumoniae and Chlamydia pneumoniae between the multiplex qPCR and the single PCR in children with CAP(P>0.05).The positive rate of multiplex qPCR was consistent with that of sputum culture,immunofluorescence and single PCR(Kappa>0.400,P<0.05).Conclusion Multiplex qPCR has a positive significance in the etiological diagnosis of CAP in children,with a high positive rat

关 键 词：儿童 社区获得性肺炎 病原学诊断 多重实时荧光定量聚合酶链反应 痰培养 免疫荧光 单重聚合酶链反应 一致性分析 

分 类 号：R563.1[医药卫生—呼吸系统] R446.1[医药卫生—内科学]