肺炎支原体肺炎患儿DNA拷贝量与临床特征及耐药性的相关性研究

Study on the correlation between DNA copy quantity and clinical characteristics,drug resistance in children with Mycoplasma pneumoniae pneumonia

目的研究肺炎支原体(MP)肺炎患儿DNA拷贝量与病情严重程度的关系。方法选取南通市第一人民医院儿科住院的肺炎支原体肺炎的158例患儿作为研究对象,采用实时荧光定量PCR法对咽拭子MP-DNA定量检测,根据检测结果分为低拷贝量组75例及高拷贝量组83例。比较不同DNA拷贝量患儿的临床症状、实验室指标、影像学表现及耐药基因检测结果。结果高拷贝量组患儿总热程、使用大环内酯类后热程、住院时间均长于低拷贝量组,差异均有统计学意义(均P<0.05),商拷贝量组患儿发生呼吸困难/窘迫、难治性肺炎支原体肺炎的比例、细胞因子及A2063G突变率均高于低拷贝量组,差异均有统计学意义(P<0.05)。结论MP肺炎患儿DNA拷贝量与病情严重度有关,MP肺炎患儿进行DNA定量检测有利于病情监测及指导临床治疗。

Objective To research the relationship between DNA copy quantity and severity of Mycoplasma pneumoniae pneumonia(MPP)in children.Methods A total of 158 children with MPP treated in Department of Pediatrics,the First People's Hospital of Nantong were selected as study object,real-time fluorescence quantitative PCR was used to quantitatively detect throat swab MP-DNA,then the children were divided into low-copy number group(75 children)and high-copy number group(83 children).The clinical symptoms,laboratory indexes,imaging manifestations,and detection results of drug resistance genes in children with different DNA copy numbers were compared.Results The total thermal process,thermal process after application of macrolides,and hospitalization time in high-copy number group were longer than those in low-copy number group,the proportions of children with breathing difficulties/respiratory distress,refractory MPP,the levels of cytokines,the mutation rate of A2063G in high-copy number group were higher than those in low-copy number group,there were statistically significant differences(P<0.05).Conclusion DNA copy number of MPP children is related to severity of the disease,DNA quantitative detection is helpful for disease monitoring and clinical guidance of treatment.