小儿肺炎支原体感染临床检验分析

Clinical analysis of pediatric Mycoplasma pneumoniae infection

目的探讨小儿肺炎支原体感染疾病诊断的检验方法 ,以期提高小儿肺炎支原体感染诊断率。方法回顾性分析200例小儿肺炎支原体感染患儿血生化、血细胞分析、血常规、细菌培养、痰支原体培养、酶联免疫法检验、冷凝集试验、血气分析等临床检验的结果。结果酶联免疫法检验结果显示,200例患儿中67例肺炎支原体上呼吸道感染,68例急性支气管炎,40例支气管肺炎,25例支气管哮喘。痰微生物培养结果显示:200例患儿中支原体阳性36例,肺炎链球菌阳性22例,肺炎克雷伯菌阳性21例,阴沟肠杆菌阳性20例。血常规结果显示:患儿的白细胞计数显著提升,其中白细胞计数<4.0×10~9/L 45例,(4.0~10.0)×10~9/L 60例,>10.0×10~9/L 95例;患者的血小板计数也显著提高,血小板计数<10.0×10~9/L 38例,>10.0×10~9/L 162例。冷凝集实验结果显示:阴性患儿81例,阳性患儿119例。血沉>20 mm/h患儿36例,C反应蛋白(CRP)>10 mg/L患儿53例。治疗后,患儿血清CRP水平为(4.41±0.13)mg/L,低于治疗前的(21.43±1.22)mg/L,差异有统计学意义(P<0.05)。结论针对小儿肺炎支原体感染,单一的检验结果缺乏诊断的特异性,很难正确判定感染类型,只有使用多种实验室检测技术,结合多种检验的结果综合分析,才能减少假阳性和假阴性,提高诊断率,更加科学有效地做出正确的诊断。

Objective To discuss the test method of diagnosis of pediatric Mycoplasma pneumoniae infection,so as to improve the diagnosis rate of pediatric Mycoplasma pneumoniae infection.Methods The clinical test results of blood biochemistry,blood cell analysis,blood routine,bacterial culture,sputum mycoplasma culture,enzyme-linked immunosorbent assay,cold agglutination test and blood gas analysis of 200 children with Mycoplasma pneumoniae infection were retrospectively analyzed.Results The results of enzyme-linked immunosorbent assay showed that there were 67 cases with upper respiratory tract infection of Mycoplasma pneumoniae,68 cases with acute bronchitis,40 cases with bronchopneumonia,and 25 cases with bronchial asthma among 200 children.The results of sputum microbial culture showed that there were 36 cases with positive Mycoplasma,22 cases with positive treptococcus pneumoniae,21 cases with positive klebsiella pneumoniae,21 cases with positive enterobacter cloacae.The results of routine blood tests showed that the blood leukocyte counts were significantly increased,including 45 cases counted 4.0×10~9/L,60 cases counted with（4.0~10.0）×10~9/L,95 cases counted 10.0×10~9/L; the patients＇ platelet count also increased significantly,only 38 cases counted 10.0×10~9/L and 162 cases counted 10.0×10~9/L.The results of cold agglutination test showed that there were 81 cases of negative children and 119 cases of positive children.In addition,36 children with erythrocyte sedimentation rate 20 mm/h and 53 children with C reactive protein（CRP）10 mg/L.After treatment,children had lower serum CRP as（4.41±0.13） mg/L than（21.43±1.22） mg/L before treatment,and the difference was statistically significant（P〈0.05）.Conclusion For children with Mycoplasma pneumoniae infection,single test results lack of specificity in diagnosis.It is difficult to determine the correct type of infection,and only the use of a variety of laboratory detection technology,combined with a variety of test results of comprehensive analysis,can reduce the false positive and false negative and improve the diagnosis rate,so as to make the correct diagnosis more scientifically and effectively.