儿童呼吸道肺炎支原体感染的实验室诊断

Laboratory diagnosis of Mycopalsma pneumoniae respiratory tract infections in children

目的同时用目前常用的几种诊断肺炎支原体(MP)感染的实验方法检测MP,相互比较,得出适于常规诊断MP感染的方法或组合。方法搜集我院于2006年10月至2007年5月间以呼吸道感染入院儿童病例75例,采集其咽拭子和双份血清标本,以多种方法检测有无MP感染:培养法、EIA法测抗原、PCR法测MP-DNA,ELISA法测MP特异性IgG、IgA型抗体以及捕获法ELISA测MP特异性IgM型抗体。结果上述75例儿童中,共计有12例感染MP。以此为基础,上述各方法的敏感度分别是:培养法(25%)、EIA法测抗原(8.3%)、PCR法测MP-DNA(75.0%)、ELISA法测MP特异性IgA型抗体(单份血清为0,双份血清为33.3%)、捕获法ELISA测MP特异性IgM型抗体(单份血清为66.7%,双份血清为100%)。特异度分别是:100%、96.8%、93.7%(93.7%)、98.4%(98.4%)。PCR法和捕获法ELISA测MP特异性IgM型抗体结合后敏感度和特异度分别达到100%和95.2%。结论PCR法测MP-DNA和捕获法ELISA测MP特异性IgM型抗体的组合可高效地诊断MP感染,因而可作为临床诊断MP感染的一个常规组合。

Objective Several commonly used methods were carried out to determine Mycoplasma pneumonia, （MP） simultaneously so as to draw out practical method or combination of methods for routine diagnosis of MP infection after the comparison with each other. Methods 75 samples were collected from the children with respiratory tract infections in our hospital from Oct 2006 to May 2007. Their throat swabs and double sera were obtained, which were analyzed using such methods： culture,EIA-Ag,PCR for MP-DNA,ELISA for IgG and IgA,capture-ELISA for IgM. Results Among those 75 samples,12 were proved to be infected by MP. On such basis,the sensitivity values were 25% ,8.3% ,75% ,0 and 33.3% （for the first and the first and second serum specimens combined,respectively） ,66.7% and 100% for those methods respectively except ELISA for IgG. The specificity values were 100% ,96. 8% ,93.7% and 93.7% ,98.4% and 98.4% , respectively. The combination of PCR for MP-DNA and capture-ELISA for IgM increased the sensitivity and specificity values up to 100% and 95.2% respectively. Conclusions The combination of PCR for MP-DNA and capture-ELISA for IgM is efficient in diagnosing MP infections, which may be used as a routine set in diagnosing MP infections clinically.