实时定量PCR方法对儿童肺炎支原体血症诊断价值研究

A study of real-time quantitative PCR to diagnose Mycoplasma pneumonia septicemia in children

目的评价实时定量PCR方法对儿童肺炎支原体血症诊断的临床应用价值，为支原体肺炎早期诊断及防控工作提供依据。方法采用实时定量PCR方法财医院儿科148例肺炎支原体（MP）感染疑似病例血清进行检测，并与临床诊断和血清免疫学结果进行比较。结果实时定量PCR方法能够检出MPDNA的浓度范围为6．4×10-2ng·μl-1～200ng·μl-1。应用实时定量PCR方法诊断MP感染的灵敏度为86．67％，特异度为91．78％，诊断符合率为89．19％，与临床诊断比较差异无统计学意义（P〉0．05）；以血清学试验结果为“金标准”，实时定量PCR方法对MP感染诊断的灵敏度为75．00％，特异度为77．63％，一致率为76．35％，两种方法差异无统计学意义（P〉0．05）；实时定量PCR方法和血清学试验联合检测对MP感染诊断的灵敏度为97．26％，特异度为78．67％，诊断符合率为87．84％，与临床诊断差异有统计学意义（P〈0．05）。结论采用实时定量PCR方法对儿童肺炎支原体血症诊断的灵敏度和特异度较高，联合血清免疫学结果检测的灵敏度可达97．26％，可供临床应用。

Objective To evaluate the clinical use of real time quantitative PCR to diagnose Mycoplasma pneumonia septicemia and provide evidence for early diagnosis and prevention of M. pneumonia. Methods Real time quantitative PCR was used to test serum samples from 148 patients in Pediatrics with a suspected M. pneumonia infection. The results of real-time quantitative PCR were compared to clinical diagnosis and serum immunology results. Results Real time quantitative PCR detected M. pneumonia at concentrations ranging from 6.4 ×10-2ng·μl-1 to 200 ng·μl-1. Real time quantitative PCR had a sensitivity of 86.67% and a specificity of 91.78% ; results of real-time quantitative PCR a greed with the diagnosis at a rate of 89. 19%. Differences between real-time quantitative PCR and clinical diagnosis were not statistically significant （P〉0.05）. With serology results as the ＂gold standard.＂ real-time quantitative PCR bad a sensitivity of 75.00%, a specificity of 77.63%, and agreed with the diagnosis at a rare of 76.35%. Differences between real-time quantitative PCR and clinical diagnosis were not statistically significant （P〉0.05）, Compared to clinical diagno sis, a combination of real-time quantitative PCR and serology had a sensitivity of 97.26%, a specificity of 78.67%, and agreed with the diagnosis at a rate of 87.84%. Differences between the combined techniques and clinical diagnosis were statistically significant （P〈0.05）. Conclusion Real time quantitative PCR had a high sensitivity and specificity. Real- time quantitative PCR in combination with serum immunology results had a sensitivity as high as 97. 26%. Real time quantitative PCR can be used in clinical diagnosis,