肺炎支原体抗体联合降钙素原对小儿支原体肺炎感染的诊断价值

Diagnostic value of combined detection of mycoplasma pneumonia antibody with procalcitonin for mycoplasma pneumoniae pneumonia in children

目的探究肺炎支原体(MP)抗体联合降钙素原(PCT)对小儿支原体肺炎(MPP)感染的诊断作用。方法选取2017年2月至2019年12月江苏省南通市第一人民医院儿科住院肺炎支原体肺炎患儿120例作为观察组,另选取同期在本院进行体检的120例健康儿童作为对照组,分别比较MP抗体、PCT及两者联合诊断小儿MPP感染的诊断价值,并对MP耐药性情况进行分析。结果观察组患儿中MP抗体检查阳性率(MP-Ab滴度≥160)高于对照组,差异有统计学意义(78.33%vs.6.67%,χ^(2)=126.104,P<0.05),观察组患儿中PCT检查阳性率高于对照组,差异有统计学意义(74.17%vs.18.33%,χ^(2)=75.240,P<0.05);MP抗体联合PCT检测小儿支原体肺炎感染灵敏度为92.50%、准确度为94.58%,显著高于MP抗体、PCT单一检测(χ^(2)值分别为9.667、10.401、14.520、28.107,P<0.05);联合检测的特异度为96.67%、阳性预测值为96.52%,显著高于PCT单一检测(χ^(2)值分别为13.976、14.815,P<0.05);联合检测的阴性预测值为92.80%,显著高于MP抗原单一检测(χ^(2)=7.704,P<0.05);120例患儿经引物探针检测23SrRNA基因2063、2064位点突变情况,显示56例(46.67%)存在耐药基因。结论MP抗体联合PCT检测能提高小儿MP感染的诊断率,临床应用价值较高,且本院小儿MP的耐药率较高。

Objective To investigate diagnostic value of combined detection of mycoplasma pneumonia(MP)antibody with procalcitonin(PCT)for mycoplasma pneumoniae pneumonia(MPP)in children.Methods 120 children with MPP who admitted to Department of Pediatrics,The First Nantong Municipal People′s Hospital from February 2017 to December 2019 were selected as observation group,and other 120 healthy children who received physical examination in the hospital in the same period were selected as control group.The diagnostic value of MP antibody,PCT and the combination of the two for children′s MPP were analyzed and compared,and resistance of MP to the drugs was analyzed.Results The positive rate of MP antibody detection(MP-Ab titer≥160)was higher in the children in the observation group than that in the control group,and the difference was statistically significant(78.33%vs.6.67%,χ^(2)=126.104,P<0.05),and also,the positive rate of PCT detection was higher in the children in the observation group than that in the control group,and the difference was statistically significant(74.17%vs.18.33%,χ^(2)=75.240,P<0.05).The sensitivity of the combined detection of MP antibody with PCT was 92.50%and the accuracy was 94.58%,which were significantly higher than those of single detection of MP antibody and PCT(χ^(2)=9.667,10.401,14.520 and 28.107 respectively,all P<0.05).The specificity of the combined detection was 96.67%,and the positive predictive value was 96.52%,which were significantly higher than those of the single PCT detection(χ^(2)=13.976 and 14.815 respectively,both P<0.05).The negative predictive value of the combined detection was 92.80%,which was significantly higher than that of the single MP antigen detection(χ^(2)=7.704,P<0.05).120 children were tested by primer probes for mutations in 23 SrRNA genes 2063 and 2064,and showed presence of drug resistance genes in 56 children(46.67%).Conclusion The combined detection of MP antibody with PCT can improve diagnosis rate of MP infection in children,with high clinical application value,however,the drug resistance rate of the children in this hospital is relatively high.