尿肺炎链球菌抗原检测在儿童肺炎链球菌肺炎诊断中的临床意义

Clinical significance of detection for urine streptococcus pneumoniae antigen in the diagnosis of children streptococcus pneumoniae pneumonia

目的 探讨尿肺炎链球菌抗原检测在儿童肺炎链球菌肺炎诊断中的临床价值.方法 选取2013-02～2014-02在广东省茂名市妇幼保健院儿科住院的小于3岁的下呼吸道感染患儿298例,入院后留取痰培养,同时用尿标本检测肺炎链球菌抗原.结果 298例患儿的痰液纯培养阳性率9.7％,尿肺炎链球菌抗原阳性率16.4％,痰液纯培养阻性组患儿的尿肺炎链球菌抗原阳性率（86.2％）明显高于阴性组（8.9％）（P＜0.01）.尿肺炎链球菌抗原检测的敏感性为86.2％,特异性为91.1％,准确度为90.6％.结论 尿肺炎链球菌抗原检测在儿童肺炎链球菌肺炎诊断中有较好的临床价值,与痰培养结合有助于提高该病的诊断准确率,值得临床推广应用.

Objective To approach the clinical value of detection for urine streptococcus pneumoniae antigen in the diagnosis of children streptococcus pneumoniae pneumonia.Methods 298 cases with lower respiratory tract infection were selected,who were treated in pediatrics department from February,2013 to February,2014.All the patients were less than 3 years old.Sputum culture and urine streptococcus pneumoniae antigen were detected at the same time.Results In the 298 cases,the positive rate of sputum pure culture was 9.7% and urine streptococcus pneumoniae antigen were 16.4%.The positive rate（86.2%） of urine streptococcus pneumoniae antigen in sputum pure culture positive group was higher than that in negative group（8.9%） obviously（P〈 0.01）.The sensitivity,specificity and accuracy of detection for urine streptococcus pneumoniae antigen were 86.2%,91.1% and 90.6%.Conclusion The detection for urine streptococcus pneumoniae antigen has superior value in the diagnosis of children streptococcus pneumoniae pneumonia.It can improve the diagnosis of the desesse accurary combined with sputum culture and worthy of clinial application.