不同呼吸道病原谱抗体IgM检测方法在呼吸道感染诊断中的应用价值比较

Comparison of the Application Value of Different Respiratory Pathogen Spectrum Antibody IgM Detection Methods in the Diagnosis of Respiratory Infection

目的:比较不同呼吸道病原谱抗体免疫球蛋白M(IgM)检测方法在呼吸道感染诊断中的应用价值。方法:选取2020年1月—2022年12月于济南市第三人民医院住院的明确诊断为呼吸道感染的500例患者作为研究对象,采集血清,分别用间接免疫荧光法(IFA)、酶联免疫吸附法(ELISA)检测呼吸道合胞病毒-IgM抗体(RSV-IgM)、腺病毒-IgM抗体(ADV-IgM)、甲型流感病毒-IgM抗体(IFZA-IgM)﹑乙型流感病毒-IgM抗体(IFZB-IgM)、副流感病毒-IgM抗体(HPIVs-IgM)、嗜肺军团菌-IgM抗体(LP-IgM)﹑肺炎衣原体-IgM抗体(CP-IgM)﹑肺炎支原体-IgM抗体(MP-IgM)。以直接免疫荧光法(DFA)结果为金标准,比较IFA、ELISA检测上述指标的符合率,比较IFA和ELISA对不同标本采集时间病原体IgM抗体检测的符合率。比较IFA和ELISA对不同疾病类型患者病原体IgM抗体检测的符合率。结果:以DFA结果为金标准,IFA检测CP-IgM、MP-IgM阳性符合率高于ELISA,差异有统计学意义(P<0.05)。IFA、ELISA在7~14 d、15~21 d、>21 d的阳性符合率明显高于<7 d,差异有统计学意义(P<0.05)。IFA检测支气管炎的阳性符合率高于咽峡炎,毛细支气管炎阳性符合率高于咽峡炎,差异有统计学意义(P<0.05);ELISA检测支气管炎的阳性符合率高于肺炎、咽峡炎,差异有统计学意义(P<0.05)。结论:IFA与ELISA均可快速检测血清lgM抗体,明确感染源,对指导治疗有积极的意义,有较高的价值。但检测结果受发病时间、疾病类型的影响,应引起重视。

Objective:To compare the application value of different respiratory pathogen spectrum antibody immunoglobulin M(IgM)detection methods in the diagnosis of respiratory infections.Method:A total of 500 patients who were hospitalized at Jinan Third People's Hospital from January 2020 to December 2022 and were diagnosed with respiratory tract infections were selected as the research subjects.Serum samples were collected,indirect immunofluorescence assay(IFA)and enzyme-linked immunosorbent assay(ELISA)were used to detect respiratory syncytial virus-IgM antibodies(RSV-IgM),adenovirus-IgM antibodies(ADV-IgM),influenza A virus-IgM antibodies(IFZA-IgM),influenza B virus-IgM antibodies(IFZB-IgM),parainfluenza virus-IgM antibodies(HPIVs-IgM),legionella pneumophila-IgM antibodies(LP-IgM),chlamydia pneumoniae-IgM antibodies(CP-IgM),and mycoplasma pneumoniae-IgM antibodies(MP-IgM).Using direct immunofluorescence assay(DFA)results as the gold standard,IFA and ELISA were used to compare the coincidence rates of the above indicators,and IFA and ELISA were used to compare the coincidence rates of pathogen IgM antibody detection in different specimen collection times.The coincidence rate of IFA and ELISA for detection of pathogen IgM antibody in patients with different disease types was compared.Result:Using DFA results as the gold standard,the positive coincidence rate of CP-IgM and MP-IgM detected by IFA were higher than those by ELISA,and the differences were statistically significant(P<0.05).The positive coincidence rate of IFA and ELISA at 7-14 d,15-21 d and>21 d were significantly higher than those at<7 d,and the differences were statistically significant(P<0.05).The positive coincidence rate of IFA in detecting bronchitis was higher than that of angina,and the positive coincidence rate of bronchiolitis was higher than that of angina,the differences were statistically significant(P<0.05).The positive coincidence rate of ELISA for bronchitis was higher than that for pneumonia and angina,and the difference was statistically significant(P<0.05).Conclusion:Both IFA and ELISA can quickly detect serum lgM antibody and identify the source of infection,which has positive significance for guiding treatment and has high value.However,the test results are affected by the time of onset and the type of disease,and should be paid attention to.