摘要
目的评价RNA恒温扩增检测技术（SAT）在儿童肺炎支原体（MP）肺炎中的诊断价值。方法选取2014年2月至11月北京儿童医院呼吸科因肺炎收住院的患儿266例，利用MP-SAT技术和血清抗体（MP—Ab）颗粒凝集法分别检测MP感染。结果1．以血清学MP—Ab检测结果为标准，MP-SAT检测的敏感度和特异度分别为75．0％和89．7％。且MP—SAT在短病程组的诊断敏感度显著高于长病程组（88．2％比67．4％，P=0．006），提示MP—SAT在疾病早期的诊断价值较好。2．MP-SAT与入院时MP-Ab检测结果一致性较差，在MPP组和非MPP组分别有45．8％（64／140例）和10．3％（13／126例）的患儿2种检测方法结果不一致；但MP—SAT与双份血清MP-Ab检测结果一致性较好（Kappa值为0．89，P〈0．001），提示MP—SAT可有效辅助临床的早期快速确诊。3．MP-SAT在≥5岁患儿中检出率高，OR为7．99（95％CI4．25～15．02），P〈0．001，主要是由于MP感染以5岁以上儿童为主；而MP-SAT在病程≤7d的患儿中检出率高，OR为0．40（95％C10．22—0．73），P=0．003，则提示MP—SAT在疾病早期阳性率高，进行该检测时应注意采集样本的时间。结论MP—SAT在儿童MP肺炎的早期诊断中的价值较高，可有效弥补血清MP-Ab存在窗口期的不足；同时MP-SAT与急性期／恢复期双份血清检测结果的一致性较好，可有效辅助临床的早期快速确诊；且临床采用MP-SAT进行MP感染检测时应尽可能在疾病的早期采集样本。
Objective To evaluate a method for detection of Mycoplasma pneumoniae pneumonia （MPP） by the RNA simultaneous amplification and testing （SAT） in children. Methods During February to November 2014, a total of 266 children with pneumonia treated in Department of Respiratory, Beijing Children＇s Hospital were enrolled in this study. RNA was tested by SAT （MP -SAT） and antibody was tested by particle agglutination assay （MP -Ab）, respectively. Results （ 1 ） With the result of MP - Ab as the reference, the sensitivity and specificity of the assay was 75.0% and 89.7% ,respectively. The sensitivity in the short course group （ ≤7 d） was significantly higher than that in the long course group （ 〉 7 d）（ 88.2% vs 67.4%, P = 0. 006）. It prompted that MP -SAT had better diagnostic value in the early stages of the disease. （2） Compared with the results of MP - SAT and MP - Ab on admission, there were 45.8% （64/140 cases） and 10.3% （ 13/126 cases） of cases with 2 inconsistent test results in MPP group and un - MPP group. But MP - SAT had good consistency with double serum MP - Ab testing result （ Kappa value was 0.89, P 〈 0.001 ）, suggesting MP - SAT could effectively assist clinical early diagnosis quickly. （ 3 ） The detection rate of MP - SAT was higher in ≥5 years old than that in 〈 5 years old group,and the OR value was 7.99 （95% CI 4.25 to 15.02 ,P 〈 0. 001 ）, which was because MP infection was given priority to those ≥5 years old children. And the detection rate of MP - SAT was higher in 〈 7 days than that in 〉17 days group, and OR value was 0.40 （95% CI 0. 22 to 0. 73,P = 0. 003）, which indicated that MP -SAT had high positive rate in the early stage of disease, and the doctors should pay attention to the time for getting the test samples. Conclusions MP - SAT is sensitive in the early stage of MPP, which can effectively make up for the inadequacy of MP - Ab. MP - SAT has good consistency with double serum detection results and can effectively assist clinical early rapid diagnosis; and doctor should get testing samples at the early stages of the disease as early as possible.
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2016年第16期1222-1226,共5页
Chinese Journal of Applied Clinical Pediatrics
基金
国家科技支撑计划（2013BA109811）
首都卫生发展科研专项（2014-1-2094）
首都卫生发展科研专项（2016-1-2092）
关键词
肺炎支原体
核酸扩增技术
诊断
儿童
Mycoplasma pneumoniae
Nucleic acid amplification techniques
Diagnosis
Child
