肺炎支原体核酸荧光PCR法与血清 被动凝集法比对分析.docVIP

肺炎支原体核酸荧光PCR法与血清 被动凝集法比对分析 　　摘要：目的：探讨肺炎支原体核酸荧光PCR法与血清学抗体检测―被动凝集法的比对关系。方法：将有咳嗽、低热、X线胸片检查有肺纹理增粗的急性上呼吸道感染的0―12岁的患儿700例分别获取咽拭子进行核酸荧光PCR法检测和静脉抽血进行血清学抗体检测。结果：上述700例患儿中，肺炎支原体核酸荧光PCR法阳性率和灵敏度在0―4岁阶段明显高于血清学检验，4―12岁阶段阳性率低于血清学检验但特异性明显高于血清学检验。结论：核酸荧光PCR法具有早期、快速、特异等优点，血清被动凝聚法灵敏度和特异性都较低，特别是婴幼儿免疫系统还未发育完善，产生抗体的速度较慢，抗体量不够，易产生假阴性。 　　关键词：肺炎支原体 荧光PCR检测 血清学抗体检测 被动凝聚 　　Comparative Analysis OfMycoplasma PneumoniaeNucleic Acid Fluore 　　-scentPCRAnd SerumPassive Agglutination 　　Shu MeilianDepartment OfHunanProvinceYuanling County Hospital Of Traditional Chinese Medicine 　　Abstract:Objective: Discussion oninspection/Mycoplasma pneumoniaenucleic acid fluorescentPCRandserum antibody ofPassive AgglutinationMethod relations.Method: There are 700cases of cough,fever,chest X-rayexamination isthe lung texture increasesacute upper respiratory tractInfectionofcoarseaged 0 to12years oldchildren,who got thepharynx swabs ofnucleic acidfluorescent PCR detectionandvenous bloodserumanti-body detection.Results: The above 700cases,Mycoplasma pneumoniae?DNAby fluorescent PCRpositive rate andsensitivity in0to 4 years oldstagewas higher than that ofserological test, 4to 12 years oldstagepositive rate of less thanserological testsbutthe specificity was higher thanseroLogiCaltest.Conclusions: Nucleic acid fluorescentPCR methodwith early,rapid,specific advantages. Serum passivecoacervationsensitivity and specificityare low,especially theinfantimmune systemdevelopment has not been perfect,antibody producingslower,antibodyis not enough,easy to producefalse negative. 　　Key words:Mycoplasma pneumoniae Fluorescent PCR detectionSerumantibody detectionPassivecondensation 　　支原体是1898年Nocard等发现的一种类似细菌，但不具有细胞壁的原核微生物[I]，肺炎支原体是人类支原体肺炎的病原体。因其没有细胞壁，所以所有抑制细菌细胞壁合成的药物，其都表现为耐药，如青霉素，支原体能在无生命的人工培养基上生长繁殖，但其生长过程较慢，对临床早期诊断意义欠佳，小儿肺部感染是儿科临床常见病与多发病，其中肺炎支原体（MP）感染占有一定的比例，支原体肺炎的病理改变以间质性肺炎为主，具有病情重，病程长等特点，有些肺炎支原体感染者可进展为重症肺炎，并发心力衰竭，呼吸衰竭，中毒性脑病等危重病症，危及患儿生命[II]，近年来小儿肺炎支原体感染发病率显著增多，具有局部流行趋势，除引起以往认为的非典型肺炎外，还可引起肺外各系统的改变，受到了临床广泛的重视。所以及早有效的检测方法显得