摘要
目的比较核酸检测与3种血清学检测方法在肺炎支原体感染诊断中的应用。方法分别采集郑州大学附属儿童医院2018年1—12月呼吸道感染住院患儿的咽拭子和血清样本,使用咽拭子进行肺炎支原体核酸检测,采用磁微粒化学发光法、酶联免疫吸附试验和被动凝集法检测肺炎支原体IgM抗体(血清样本)。通过抗体动态监测进一步分析核酸和IgM抗体检测结果不一致的样本。结果核酸检测肺炎支原体阳性96例,阴性112例,核酸与3种血清学方法结果的一致性均为中等(Kappa值0.457~0.509),而3种血清学方法之间的结果一致性较高(Kappa值0.841~0.932)。31.25%(30/96)的急性感染者入院时核酸为阳性而IgM抗体检测为阴性,但是根据IgG抗体的动态变化分析,其中有11.46%(11/96)的患者可以排除急性感染,可能是感染后的长期定植,10.71%(12/112)的患者可能因样本采集不准确导致核酸检测结果出现漏检。结论核酸和IgM抗体的检测各有优劣,在应用中需结合临床诊断和发病时间综合考虑。
Objective To compare the nucleic acid testing and three serological detection methods in the diagnosis of Mycoplasma pneumoniae infection.Methods Throat swabs and serum samples were collected from children hospitalized with respiratory infections from January to December 2018 in the Children’s Hospital Affiliated to Zhengzhou University,throat swabs was used for Mycoplasma pneumoniae nucleic acid testing,and magnetic particle chemiluminescence,enzyme-linked immunosorbent assay and passive agglutination were used to detect Mycoplasma pneumoniae IgM antibodies(serum samples).The samples with inconsistent nucleic acid and IgM antibody test results were further analyzed by antibody dynamic monitoring.Results There were 96 positive cases and 112 negative cases in nucleic acid detection of Mycoplasma pneumoniae.The consistency between nucleic acid and the three serological methods was medium(Kappa value was 0.457 to 0.509),while the consistency among the three serological methods was high(Kappa value was 0.841 to 0.932).31.25%(30/96)of the acutely infected patients were nucleic acid positive but IgM negative on admission,however,based on the analysis of dynamic changes of IgG antibodies,11.46%(11/96)of the patients could be excluded from acute infection,possibly colonization after infection,10.71%(12/112)of the patients may have missed nucleic acid test results due to inaccurate sample collection.Conclusion The detection of nucleic acid and IgM antibody has its advantages and disadvantages,which should be considered in combination with clinical diagnosis and onset time.
作者
陶占领
孙红启
杨俊梅
张哲莹
TAO Zhanling;SUN Hongqi;YANG Junmei;ZHANG Zheying(Department of Pathology,Xinxiang Medical University Basic Medical College,Xinxiang 453003,China;Department of Laboratory,Children’s Hospital Affiliated to Zhengzhou University,Zhengzhou 450016,China;Zhengzhou Key Laboratory of Children’s Infection and Immunity,Zhengzhou 450016,China)
出处
《河南医学研究》
2023年第24期4433-4436,共4页
Henan Medical Research
基金
河南省医学科技攻关计划联合共建项目(2018020698)。
关键词
肺炎支原体
血清学
核酸
抗体
Mycoplasma pneumoniae
serology
nucleic acid
antibody
