两种血清学检测方法在婴、幼儿肺炎支原体感染早期诊断中的应用研究

Application research of two serological tests in early diagnosis of Mycoplasma pneumoniae infection in infants and young children

目的 比较和分析肺炎支原体抗体的两种血清学检测方法,探讨其在婴、幼儿肺炎支原体感染早期诊断中的临床意义.方法 收集急性呼吸道感染患儿3 365例,根据不同年龄将其分为0～〈1岁组（n=1 267）、1～〈3岁组（n=1 709）、3～〈6岁组（n=257）、6～〈13岁组（n=132）.采用被动颗粒凝集法（PPA）及间接免疫荧光法（IFA）检测肺炎支原体抗体MP-IgM,对IFA和PPA检测结果不一致的患儿进行双份血清MP-IgM抗体效价检测.结果 0～〈1岁和1～〈3岁组患儿IFA检测的MP-IgM阳性率高于PPA检测（P＜0.01）,3～〈6岁组和6～〈13岁组患儿采用两种方法检测的MP-IgM阳性率比较,差异无统计学意义（P〉0.05）.两种检测方法的阳性符合率为95.53%（1 113/1 165）,阴性符合率为89.45%（1 968/2 200）,总符合率为91.56%（3 081/3 365）.28例患儿双份血清MP-IgM抗体效价检测中,24例患儿的肺炎支原体抗体升高4倍.结论 IFA和PPA联合检测可有效提高肺炎支原体感染早期诊断的敏感性和特异性.

Objective To compare and analyze the two serological tests for Mycoplasma pneumoniae antibody and discuss their clinical significance in early diagnosis of Mycoplasma pneumoniae infection in infants and young children. Methods 3 365 children with acute respiratory infection were collected and divided into 0-〈1- year old group（n= 1 267）, 1- 〈3-year old group（n= 1 709）, 3-〈6-year old group（n= 257） and 6 - 〈13 - year old group（n= 132） according to different ages. Passive particle aggluti- nation（PPA） and indirect immunofluorescence assay（IFA） were employed to detect the Mycoplasma pneumoniae antibody MP- IgM. Detection of MP-IgM antibody titer was performed in double serum samples of children whose IFA and PPA results were inconsistent. Results Positive detection rates of MP-IgM of children in 0-〈 1- year old group and 1- 〈3-year old group using IFA method were higher than those using PPA method（P〈0.01）. Compared the positive detection rates of MP-IgM of children in 3-〈6-year old group and 6-〈 13-year old group between the two detection methods, difference showed no statistical significance（P〈0.05）. Coincidence rate of positive results of the two detection methods was 95.53%（1 113/1 165）, while that of negative results was 89.45〈（1 968/2 200） and the total coincidence rate was 91.56%（3 081/3 365）. In the detection of MP-IgM anti- body titer in 28 cases of double serum samples,Mycoplasma pneumoniae antibodies of 24 children were found to be increased 4 times. Conclusion IFA and PPA joint detection may effectively improve the sensitivity and specificity of early diagnosis of Mycoptasma pneumoniae infection.