微生物快速培养与抗体检测在儿童肺炎支原体感染中的应用效果评价

Evaluation of microbiological culture and IgM detection in children with Mycoplasma pneumoniae infection

目的 比较微生物快速培养和IgM抗体检测在儿童肺炎支原体(MP)感染中的应用效果。方法 2017年6月-2018年6月间湖南中医药大学第一附属医院收治的155例肺炎支原体感染患儿及同期健康体检儿童105人,取咽拭子样本进行微生物快速培养,同时检测血清MP-IgM,对比两种方法的检测结果与诊断效能。结果 当病程<7 d时,快速培养法的灵敏度为74.66%,高于MP-IgM(68.00%);MP-IgM检测的特异性为82.54%,高于快速培养法(76.19%),两者的约登指数均为0.505,曲线下面积大致相当(Z=0.060,P=0.952>0.05)。病程≥7 d时,MP-IgM检测的灵敏度(93.75%)及特异性(95.24%)均高于快速培养法(75.00%,71.23%),ROC曲线下面积为0.945,高于快速培养法(0.756)(Z=3.942,P=0.000<0.05)。在忽略病程的情况下,MP-IgM检测的ROC曲线下面积(0.845)高于快速培养法(0.755)(Z=3.188,P=0.001<0.05)。结论 MP-IgM检测用于儿童肺炎支原体感染的诊断效能更高,尤其适用于病程超过7 d的患儿。

Objective To compare the efficacy of microbiological rapid culture and IgM detection in the children with Mycoplasma pneumoniae(MP)infection.Methods A total of 155 children with MP infection and 105 healthy children in First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from June 2017 to June 2018 were enrolled in this study.The throat swab samples were used to conduct microbiological rapid culture,and MP-IgM was detected from the serum samples.The test results and diagnostic efficacy of the two methods were compared.Results When the patients’disease course was less than 7 d,the sensitivity of rapid culture was 74.66%,which was higher than that of MP-IgM detection(68.00%).However,the specificity of MP-IgM test was 82.54%,which was higher than that of rapid culture(76.19%).The Jordan index of both methods was 0.505,and the area under the ROC curve was approximately same(Z=0.060,P=0.952>0.05).When the course of disease≥7 d,the sensitivity and specificity of MP-IgM detection(93.75%,95.24%)were both higher than those of rapid culture(75.00%,71.23%),the Jordan index was 0.863,and the area under the ROC curve of MP-IgM detection was 0.945,higher than that of rapid culture(0.756)(Z=3.942,P=0.000<0.05).When the course of disease was ignored,the area under the ROC curve detected by MP-IgM(0.845)was higher than rapid culture(0.755)(Z=3.188,P=0.001<0.05).Conclusion MP-IgM detection was more effective in the diagnosis of Mycoplasma pneumoniae infection in children,especially in the children with disease course over 7 days.