酶联免疫吸附试验与冷凝集试验对诊断早期肺炎支原体感染的临床价值比较

The clinical value of ELISA versus cold agglutination test in early diagnosis of Mycoplasma pneumoniaeinfection

目的比较酶联免疫吸附试(ELISA)检测肺炎支原体Ig M(MP-Ig M)与冷凝集试验对早期诊断肺炎支原体感染的临床价值。方法采用ELISA与冷凝集试验两种方法同时检测确诊为肺炎支原体感染患儿血清标本500例。结果 ELISA法阳性率54.8%明显高于冷凝集28.4%,差异有统计学意义(χ2=71.72,P<0.01)。发热1~3 d、4~7 d、8~14 d、≥15 d其ELISA阳性率44.2%、46.4%、71.3%、78.6%均分别明显高于冷凝集22.1%、25.4%、35.7%、35.7%,发热天数延长两者阳性率均增高。ELISA检测MP-Ig M在1~3 d和4~7 d阳性率差异有统计学意义(P>0.05),1~3 d和4~7 d与8~14 d其阳性率分别为42%、46.4%、71.3%,差异有统计学意义(P<0.05),8~14 d与≥15 d其阳性率为71.3%和78.6%,差异有统计学意义(P>0.05)。结论临床检测中,优先选用ELISA检测MP-Ig M,应在发热8~14 d内检测,可以在早期明显提高支原体感染检出率,为临床诊断提供最有用的价值。

Objective To compare the clinical value of ELISA for detection of Mycoplasma pneumoni- aelgM （MP-IgM） with that of cold agglutination test in the early diagnosis of Mycoplasma pneumoniae infection. Methods ELISA and cold agglutination test were used to detect 500 serum samples from children infected with Myeoplasma pneumonia. Results The positive rate of ELISA （54.8%） was significantly higher than that of cold agglutination （28.4%）, and there was significant difference （ X2 = 71.72, P 〈 0.01 ） .The positive rates of ELISA in the children having fever for 3 days （44.2%）, 4 -7 days （46.4%）, 8 - 14 days （71.3%）, and 15 days （78.6%） were significantly higher than those of cold agglutination 22.1%, 25.4%, 35.7%, and 35.7%, respectively. The positive rates were increased with prolonged fever days. These were no significant differences on days 1 - 3, 4 - 7, 8 - 14 and 15 or longer （P 〉 0.05） by ELISA, while there was a significant difference between days 8 - 14 and both days 1 - 3 and 4 - 7 （P 〈 0.05 ）. Conclusions Detection of MP-IgM byELISA should be preferentially select- ed, especially in those having fever within 8 - 14 days. It can obviously improve the early detection rate of myeo- plasma infection and give the most useful value for clinical diagnosis.