实时定量PCR和ELISA检测支原体感染在儿童肺炎诊断中的应用

Application of real-time quantitative PCR and ELISA in diagnosis of mycoplasma pneumoniae pneumonia of children

目的对比分析荧光实时定量PCR技术和ELISA技术在检测支原体肺炎中的可靠性和优劣性,探讨更加准确、快速的检测方法。方法收集本院儿科治疗的呼吸道感染患者446例,根据年龄将患者分组。收集患者咽拭子用于实时定量PCR检测肺炎支原体DNA(MP-DNA),收集血液用于酶联免疫吸附实验(ELISA)检测肺炎支原体抗体(MPIgM)。结果实时定量PCR技术检测MP-DNA总阳性率为37.00%,其中各年龄段阳性率分别为39.44%、37.31%、35.11%、28.95%,阳性检测率随年龄增加而降低;ELISA方法检测MP-IgM总阳性率为37.44%,其中各年龄段阳性率分别为18.89%、46.27%、50.00%、63.16%,阳性检测率随年龄增加而增加(P<0.05),PCR方法婴儿组患者检出率明显高于血清ELISA方法。结论 2种方法检测MP阳性率差异无统计学意义,但实时定量PCR法在1岁以下的阳性检出率更高(P<0.05),2种检测方法联合应用可更好地指导临床治疗。

Objective To compare the reliability,advantages and disadvantages of fluorescent quantitative real-time PCR and ELISA in clinical detection of mycoplasma pneumoniae in children,so as to find a more accurate and rapid detection method.Methods Four hundred and forty-six patients with respiratory tract infections were collected from pediatrics department of this hospital and grouped by age.Throat swab specimens were sampled from these cases to detect mycoplasma pneumoniae DNA（MP-DNA） by quantitative real-time PCR,and blood specimens were collected to detect the mycoplasma pneumoniae IgM（MP-IgM） by ELISA.Results The total positive rate of MP-DNA was 37.00% in the 446 cases,and that of each age group was39.44%,37.31%,35.11% and 28.95% respectively,showing obvious negative correlation with age.While the total positive rate of MP-IgM was 37.44% in the 446 cases,and that of each age group was 18.89%,46.27%,50.00% and 63.16% respectively,showing obvious positive correlation with age（P〈0.05）.Quantitative real-time PCR showed higher positive rate than that of ELISA.Conclusion There was no statistical difference between quantitative real-time PCR and ELISA in detection of mycoplasma pneumoniae in children,but the positive rate of quantitative real-time PCR was higher than ELISA in patients under 1 year old（P〈0.05）.Combination of the two methods can better guide the clinical treatment of pediatric mycoplasma pneumoniae pneumonia.