肺炎支原体RNA与肺炎支原体免疫球蛋白M和免疫球蛋白G水平的关联研究

Association of mycoplasma pneumoniae RNA with mycoplasma pneumoniae immunoglobulin M and immunoglobulin G levels

目的探讨肺炎支原体(MP)RNA与MP-免疫球蛋白(Ig)M、MP-IgG的相关性。方法选取2019年5—9月就诊于山东第一医科大学附属省立医院的686例疑似呼吸道感染患儿,根据患儿年龄将其分为0~<4岁组(298例)、4~7岁组(276例)和>7岁组(112例)。所有患儿同时检测咽拭子MP-RNA表达及血清MP-IgM、MP-IgG水平。比较不同年龄组、性别间MP-RNA阳性率。记录MP-IgM、MP-IgG阳性率,MP-RNA与MP-IgM、MP-IgG的诊断符合率。采用受试者工作特征(ROC)曲线分析MP-IgM、MP-IgG在MP感染中的诊断价值。结果686例疑似呼吸道感染患儿中,175例(25.5%)MP-RNA阳性,4~7岁组MP-RNA阳性率高于0~3岁组、>7岁组(P<0.05)。男、女MP-RNA阳性率比较差异无统计学意义(P>0.05)。体液免疫检测结果显示,MP-IgM阳性MP-IgG阳性组MP-RNA阳性率最高[59.4%(114/192)],与其他组合比较差异有统计学意义(χ^(2)=184.29,P<0.05)。MP-RNA与MP-IgM的诊断符合率高于MP-RNA与MP-IgG的诊断符合率(P<0.05)。对MP感染诊断价值的ROC曲线分析结果显示,MP-IgM曲线下面积为0.858、敏感度为76.00%、特异度为83.37%,MP-IgG曲线下面积为0.755、敏感度为54.85%、特异度为88.46%。MP-RNA阳性率分别随MP-IgM和MP-IgG水平的升高而增高,差异均有统计学意义(均P<0.05)。结论MP-RNA的阳性率随MP-IgM和MP-IgG水平的增高而增高,MP-IgM阳性且MP-IgG阳性患儿MP-RNA阳性率最高。

Objective To investigate the correlation of mycoplasma pneumoniae(MP)-RNA with MP-immunoglobulin(Ig)M and MP-IgG.Methods From May to September 2019,686 children with suspected respiratory infection admitted to Shandong Provincial Hospital Affiliated to Shandong First Medical University were selected.According to the age,they were divided into 0-<4 years group(298 cases),4-7 years group(276 cases)and>7 years group(112 cases).All children were detected the expression of throat swabs MP-RNA and serum levels of MP-IgM and MP-IgG.MP-RNA positive rates in different age groups and gender were compared.The positive rates of MP-IgM and MP-IgG,and diagnostic concordance rates of MP-RNA with MP-IgM and MP-IgG were recorded.Receiver operating characteristic(ROC)curve was used to analyze the predicting value of MP-IgM and MP-IgG in MP infection.Results Among the 686 cases of suspected respiratory infection,there were 175 cases(25.5%)with positive MP-RNA.The positive rate of MP-RNA in 4-7 years group was higher than that in 0-3 years group and>7 years group(P<0.05),but there was no significant difference in positive rate of MP-RNA between male and female(P>0.05).Humoral immunity detection showed that the positive rate of MP-RNA in the positive MP-IgM and positive MP-IgG group was the highest[59.4%(114/192)](χ^(2)=184.29,P<0.05).The diagnostic concordance rate of MP-RNA with MP-IgM was higher than that of MP-RNA with MP-IgG(P<0.05).ROC curve analysis in diagnosis of MP infection showed that the area under the curve(AUC)of MP-IgM was 0.858,sensitivity was 76.00%and specificity was 83.37%;the AUC of MP-IgG was 0.755,sensitivity was 54.85%and specificity was 88.46%.The positivity rate of MP-RNA increased with the increasing levels of MP-IgM and MP-IgG,respectively(both P<0.05).Conclusions The positivity rate of MP-RNA increases with the increasing levels of MP-IgM and MP-IgG.Children with positive MP-IgM and positive MP-IgG have the highest rate of positive MP-RNA.