儿童疑似肺炎支原体感染者血清、支气管灌洗液、胸腔积液、脑脊液MP-Ab-IgM检测的结果分析

Analysis of the Results of MP-Ab-IgM Detection of Serum,Bronchial Lavage Fluid,Pleural Effusion and Cerebrospinal Fluid in Children Suspected of Mycoplasma Pneumoniae Infection

目的分析肺炎支原体肺炎(MPP)患儿血清、支气管灌洗液、胸腔积液及脑脊液的肺炎支原体(MP)MP-Ab-IgM检测结果。方法选取2013年3月~6月在首都医科大学附属北京儿童医院疑似MP感染的278例住院患儿的血清、支气管灌洗液、胸腔积液及脑脊液标本,采用颗粒凝集的方法检测MP-Ab-IgM。结果 181例患儿(男孩104例,女孩77例)的不同标本中MP呈阳性反应。278例患儿均进行了血清标本检测,共检出阳性血清标本170例,总检出率为61.2%(170/278),144例同时进行了支气管灌洗液检测,检出阳性62例,检出率为43.1%(62/144);19例同时进行了胸腔积液标本检测,检出阳性13例,检出率为68.4%(13/19);15例同时进行了脑脊液标本检测,检出阳性1例,检出率为6.7%(1/15)。各年龄组间检出率分别为:6个月~1岁组29.0%(9/31),~3岁组51.0%(25/49),~5岁组56.1%(23/41),~16岁组79.0%(124/157),6个月~1岁组与其他年龄组比较差异有统计学意义(P<0.05);~3岁与~5岁组间差异无统计学意义(P>0.05),而与~16岁组间差异有统计学意义(P<0.05)。在6个月~1岁,~3岁,~5岁,~16岁四个年龄组中,同一患儿检测的不同类型MP-Ab-IgM阳性标本,其对应结果为A:血清类(111例)7,21,13和70;B:血清-支气管灌洗液类(45例)0,2,5和38;C:血清+胸腔积液类(7例)0,1,2和4;D:血清+脑脊液(1例)0,0,0和1;E:血清+支气管灌洗液+胸腔积液类(6例)0,0,2和4;F:支气管灌洗液类(11)2,1,1和7。结论 MP感染多种多样,有低龄化趋势,且有逐年增多的趋势。不同年龄组间血清阳性检出率随年龄增长逐渐增加,婴幼儿阳性检出率明显升高,重症患儿多发于年龄较大的患儿。

Objective To study the infection of MP-Ab-IgM（MP）in serum,bronchial lavage fluid,pleural effusion and cerebrospinal from pediatric patients with Mycoplasma Pneumoniae Pneumonia（MPP）.Methods From March to June 2013,278 cases of patients suspected MP infection in Children＇s Hospital Affiliated to Capital Medical University were selected and the MP-Ab-IgM of theire serum,bronchial lavage fluid,pleural effusion and cerebrospinal fluid specimens were detected with the method of particle agglutination test.Results 181 cases（104 cases of boys,77 cases of girls）of different specimens in（MP）were positive.All the serum samples,278 cases were detected positive serum specimen of 170 cases,the overall detection rate was 61.2%（170/278）,144 cases of bronchial lavage fluid was investigated at the same time,check out the positive 62 cases,and the detection rate was 43.1%（62/144）.19 cases for pleural effusion samples at the same time,checked out the positive 13 cases,and detection rate was 68.4%（13/19）.15 cases of cerebrospinal fluid specimens was investigated at the same time,checked out the positive in 1 case,and the detection rate was 6.7%（1/15）.Positive rate between different age groups was respectively：6 months^1 year group 29.0%（9/31）,~3 year group 51.0%（25/49）,~5 year group56.1%（23/41）,~16 year group 79.0%（124/157）,6 months^1 year with other age groups was statistically significant difference（P〈0.05）.In 0.5~1 year,~3 year,~5 year,16 year^four age groups,different types of MP-Ab-IgM positive specimens of the same patients,the corresponding results for A：serum type（111 cases）7,21,13,70.B：serum and bronchoalveolar lavage fluid type（45 cases）0,2,5,38.C：Serum pleural effusion（7 cases）0,1,2,4.D：serum and cerebrospinal fluid（1 cases）0,0,0,1;E：serum and bronchoalveolar lavage fluid and pleural effusion type（6 cases）：0,0,2,4.F：bronchoalveolar lavage fluid type（11）2,1,1,7.Conclusion MP infection varied,have atrend of younger age,and has a tendency to increase year by year,and the patient＇s infection rates have different characteristics.Positive serum of different age groups was gradually increased with age,infants and young children positive detection rate increased significantlychildren with severe multiple in older children.