被动凝集法检测肺炎支原体抗体的实验室研究

Mycoplasma pneumoniae antibody detection by passive agglutination

目的：研究被动凝集法（日本富士肺炎支原体抗体检测试剂盒SERODIA@-MYCOⅡ）检测肺炎支原体（myco-plasma pneumoniae,MP）抗体的诊断价值。方法：收集2006年1月～2008年12月入住浙江省丽水市中心医院儿科病房患儿669例,采集患者血清一份,记录样本采集时的发病时间,分别用被动凝集法（PA）、肺炎支原体IgM酶联免疫吸附试验（ELISA）、金标渗滤法和冷凝集试验检测;重点分析了被动凝集法不同滴度作为cutoff值的灵敏度和特异性,分析不同感染天数与该方法测得的几何平均滴度的关系。结果：被动凝集法有最高的阳性率（55.85%）,被动凝集法与其他几种实验方法之间阳性率有统计学差异（P〈0.05）。PA的cutoff值分别为1：40、1：80、1：160、1：320、≥1：640时,PA的灵敏度和特异性分别为90.7%和83.3%、81.4%和93.0%、72.1%和96.9%、55.8%和98.3%、51.2%和99.4%,几何平均滴度随测定患者感染天数增加而增加。结论：被动凝集法更能精确测定抗体滴度,敏感度高,操作简单,有重要的临床应用价值,可在临床推广使用。被动凝集法cutof...

Objective：To study the diagnostic value of the passive agglutination assay（SERODIA@-MYCOⅡ） for the detection of Mycoplasma pneumoniae（mycoplasma pneumoniae,MP） antibodies.Methods：669 pediatric patients hospitalized in Zhejiang Lishui Central hospital from January 2006 to December 2008 were studied.Serum specimens of the patients were obtained 1 to 3 weeks after the infection and detected with passive agglutination（PA）,pneumonia Mycoplasma IgM enzyme-linked immunosorbent assay（ELISA）,gold assay and cold hemagglutination;we especially analysed the sensitivity and specificity of the different passive agglutination titer as a cutoff value,the relationship between infection days and geometric mean titer of passive agglutination.Results：The positive rate of passive agglutination was the highest（55.85%）,it has significant difference compared with other method（P0.05）;when the cutoff values of PA were 1：40,1：80,1：160,1：320,≥ 1：640,respectively,the sensitivity of PA test were 90.7%,81.4%,72.1%,55.8%,51.2%,and the specificity were 83.3%,93.0%,96.9%,98.3%,99.4%.The geometric mean titer of PA in patients was increased with the infection days.Conclusion：Our results demonstrate that passive agglutination measured antibody titers more accurately,sensitivity,simple operation,there are important clinical value,suitable for clinical use.A PA antibody titer of 1：80 or 1：160 has the better specificity and sensitivity,it is useful for the serological diagnosis of M.pneumoniae infection.The PA antibody titers showed a marked increase when 7 days after infection.Negative patients in the initial detection usually needed a second serum to determine the infection,when the titers equal to or exceeding 1：160 to be indicative of acute Mycoplasma pneumoniae infection.