肺炎支原体IgM抗体、WBC、CRP联合检测在儿童肺炎支原体早期感染诊断中应用

Application of IgM antibody combined with WBC and CRP in early diagnosis of children with Myocoplasima pneumonia infection

目的:探究肺炎支原体(Mycoplasma Pneumonia,MP)IgM抗体、白细胞计数(White blood cell count,WBC)、C-反应蛋白(C-reactive protein,CRP)联合检测在儿童MP早期感染诊断中的临床价值。方法:选取我院儿科门诊2022年1月至2023年12月期间诊治的120例急性呼吸道感染患儿为疾病组,另选取同期接受常规体检的50例健康儿童为健康对照组,疾病组患儿根据实验室培养及病毒学检查结果分为细菌感染组(n=45)及MP组(n=75),比较3组患儿的MP-IgM、WBC及CRP水平,同时根据重症诊断标准,将MP组患儿分为重症组(n=24)及普通组(n=51),比较MP-IgM、WBC及CRP水平,并通过受试者工作特征曲线(Receiver operating characteristic curve,ROC)分析MP-IgM、WBC、CRP单独及联合鉴别儿童MP肺炎及病情程度的效能。结果:MP组患儿的MP-IgM阳性率高于细菌感染组及健康对照组(P<0.05),而细菌感染组与健康对照组患儿MP-IgM阳性率比较无统计学差异;细菌感染组及MP组患儿血清WBC、CRP水平均高于健康对照组儿童,且细菌感染组的WBC、CRP水平高于MP组患儿(P<0.05)。MP-IgM阳性、WBC、CRP等作为检验变量进行ROC分析结果显示:MP-IgM、WBC、CRP单独及联合早期诊断MPP的AUC为0.713、0.839、0.884、0.980。重症组MP患儿MP-IgM阳性率、WBC、CRP均高于普通组(P<0.05);MP-IgM、WBC、CRP单独及联合评估重症MP感染的AUC分别为0.627、0.670、0.801、0.934。结论:MP-IgM抗体联合WBC、CRP在鉴别早期MP感染中效能较高,且在重症MP患儿早期识别中也有一定的参考价值。

Objective:To explore the clinical value of IgM antibody combined with white blood cell count(WBC)and C-reactive protein(CRP)in the early diagnosis of children with Myocoplasima pneumonia(MP)infection.Methods:A total of 120 children with acute respiratory infection and 50 healthy children who underwent routine physical examination in pediatric outpatient department of the hospital were enrolled as disease group and healthy control group between January 2022 and December 2023,respectively.According to results of laboratory culture and virological examination,children in disease group were divided into bacterial infection group(n=45)and MP group(n=75).The levels of MP-IgM,WBC and CRP in the three groups were compared.According to diagnostic criteria of severe disease,children in MP group were divided into the severe group(n=24)and common group(n=51),and levels of MP-IgM,WBC and CRP were compared between the two groups.The diagnostic efficiency of MP-IgM,WBC,CRP and combined detection for MP and its severity was analyzed by receiver operating characteristic(ROC)curves.Results:The positive rate of MP-IgM in MP group was higher than that in bacterial infection group and healthy control group(P<0.05),but there was no significant difference between bacterial infection group and healthy control group The levels of serum WBC and CRP were gradually decreased in bacterial infection group,MP group and healthy control group(P<0.05).The results of ROC curves analysis showed that AUC values of MP-IgM,WBC,CRP and combined detection in the early diagnosis of MPP were 0.713,0.839,0.884 and 0.980,respectively.The positive rate of MP-IgM,WBC and CRP in severe group were higher than those in common group(P<0.05).AUC values of MP-IgM,WBC,CRP and combined detection for evaluating severe MP infection were 0.627,0.670,0.801 and 0.934,respectively.Conclusion:MP-IgM antibody combined with WBC and CRP has high diagnosis efficiency for early MP infection,which also has certain reference value in the early identification of children with severe MP.