摘要
目的难治性肺炎支原体肺炎及重症肺炎病情重,并发症多,严重影响患儿健康及日后生活,需尽早明确诊断及治疗。本研究采用实时荧光核酸恒温扩增检测技术(simultaneous amplification and testing,SAT)对社区获得性肺炎患儿咽拭子及肺炎支原体肺炎患儿肺泡灌洗液标本进行检测,评估其在儿童肺炎支原体肺炎中应用价值。方法选取2017-09-01-2018-12-31郑州大学附属儿童医院住院的社区获得性肺炎患儿300例,并采用颗粒凝集法检测肺炎支原体血清抗体(pneumonia mycoplasma serum antibody,MP-Ab)、SAT检测肺炎支原体RNA;评估SAT在肺炎支原体肺炎临床诊断中的实用价值。结果SAT检测阳性共128例,其中肺炎支原体肺炎患儿120例,非肺炎支原体肺炎患儿8例;单份肺炎支原体血清抗体阳性125例,其中肺炎支原体肺炎91例,非肺炎支原体肺炎34例。SAT用于诊断肺炎支原体肺炎的真实性(约登指数=0.83)高于单份肺炎支原体血清抗体(约登指数=0.46);SAT用于诊断肺炎支原体肺炎时,与临床的一致性(Kappa值=0.84,P<0.001)高于单份肺炎支原体血清抗体(Kappa值=0.47,P<0.001)。56例肺炎支原体肺炎患儿进行肺泡灌洗检测,灌洗液阳性53例,咽拭子阳性51例,两种标本阳性检出率差异无统计学意义,χ2=2.322,P=0.128。结论SAT在肺炎支原体肺炎的诊断中应用价值高;SAT在不同类型标本中的肺炎支原体检出一致性好。
OBJECTIVE Mycoplasma pneumoniae pneumonia and severe pneumonia are serious and have many complications,which seriously affect children's health and future life.It is necessary to make a definite diagnosis and treatment as soon as possible.In this study,real-time fluorescent nucleic acid constant temperature amplification and testing(SAT)is used to detect pharyngeal swabs and alveolar lavage fluid samples of children with community acquired pneumonia and mycoplasma pneumoniae pneumonia,and to evaluate its application value in children with mycoplasma pneumoniae pneumonia.METHODS Totally 300children with community acquired pneumonia admitted to Children's Hospital Affiliated to Zhengzhou University from September 1,2017to December 31,2018were selected,and serum antibodies against mycoplasma pneumoniae(MP-Ab)and mycoplasma pneumoniae RNA(SAT)were detected by particle agglutination method.The practical value of SAT in clinical diagnosis of mycoplasma pneumonia was evaluated.RESULTS There were 128positive SAT tests,including 120children with mycoplasma pneumoniae pneumonia,8children with non-pneumoniae pneumonia,and 125cases with a single serum of Mycoplasma pneumoniae,including 91cases of mycoplasma pneumoniae pneumonia and 34cases of non-pneumoniae pneumonia.The authenticity of SAT for the diagnosis of mycoplasma pneumoniae(Jordan's index=0.83)was higher than that of a single pneumoniae serum antibody(Jordan's index=0.46).SAT was used for the diagnosis of mycoplasma pneumoniae pneumonia,and the clinical consistency(Kappa value=0.84,P<0.001)was higher than a single dose of mycoplasma pneumoniae serum antibody(Kappa value=0.47,P<0.001).Totally 56children with pneumococcal pneumonia were examined for alveolar lavage,53cases were positive for lavage and 51cases were positive for throat swab.There was no significant difference in the positive rate of sputum between the two samples,χ2=2.322,P=0.128.CONCLUSION The SAT has a high value in the diagnosis of Mycoplasma pneumoniae pneumonia;the SAT has a good consistency in de
作者
陈丹
杨晓林
刘满菊
CHEN Dan;YANG Xiao-Lin;LIU Man-Ju(Department of Respiratory,Children's Hospital Affiliated to Zhengzhou University,Henan Children's Hospital,Zhengzhou Children's Hospital,Zhengzhou 450007,P.R.China;Department of Pediatrics,Sanmenxia Hospital of the Yellow Rier,Sanmenxia 472000,P.R.China)
出处
《社区医学杂志》
2020年第1期28-31,共4页
Journal Of Community Medicine
基金
河南省医学科技攻关计划(2018020632)。
关键词
肺炎支原体
社区获得性肺炎
核酸恒温扩增
肺泡灌洗
mycoplasma pneumoniae
community acquired pneumonia
nucleic acid constant temperature amplification
bronchoalveolar lavage
