荧光定量PCR诊断肺炎支原体感染的临床价值评估

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目的通过采集临床诊断肺炎支原体感染患儿咽拭子及血清样本,以血清学诊断方法为对照,评估以社区获得性肺炎呼吸窘迫综合征毒素(Community-acquired respiratory distress syndrome toxin gene,CARDS)编码基因为目的基因的荧光定量PCR诊断肺炎支原体感染的临床诊断价值。方法采集临床诊断肺炎支原体感染患儿的咽拭子及急性期、恢复期血清样本,及健康儿童的咽拭子样本,以单次检测血清特异性抗体滴度≥1∶160或双份血清抗体滴度4倍及以上升高或降低为对照,评估以CARDS编码基因为目的基因的荧光定量PCR诊断肺炎支原体感染的临床诊断价值。结果采用以CARDS编码基因为目的基因的荧光定量PCR检测临床诊断为肺炎支原体感染患儿及健康儿童咽拭子样本各94例,肺炎支原体检出率分别为71.20%和15.96%。采用被动凝集法,以单次检测血清特异性抗体滴度≥1∶160或双份血清抗体滴度的4倍及以上升高或降低为确诊依据,血清学检测肺炎支原体阳性率为77.6%。以CARDS编码基因为目的基因的荧光定量PCR诊断肺炎支原体感染与对照标准符合率为80.85%,敏感度为83.56%,有较高的敏感度和符合率,特异度为71.43%,相对低。约登指数为0.55,ROC曲线下面积为0.696,提示对肺炎支原体感染的诊断有一定准确性。结论以CARDS的编码基因为目的基因的荧光定量PCR诊断肺炎支原体感染,有一定的准确性,快速、敏感,对肺炎支原体的早期诊断有参考价值,由于肺炎支原体有健康携带,特异度受到影响,诊断肺炎支原体感染需结合血清学及临床。 Objective To collect throat swabs and serum samples from children with mycoplasma pneumoniae infection by clinical diagnosis and to evaluate the risk of community-acquired respiratory distress syndrome toxin (CARDS) Because of the purpose of gene fluorescence quantitative PCR diagnosis of Mycoplasma pneumoniae infection clinical diagnostic value. Methods Throat swabs, acute and convalescent serum samples from throat swabs and throat swabs from healthy children were collected for clinical diagnosis of mycoplasma pneumoniae infection. A single serum titer ≥1: 160 or serum antibody Titer 4 times and above as the control, to evaluate the clinical diagnostic value of using fluorescence quantitative PCR (PCR) with CARDS gene as the target gene to diagnose Mycoplasma pneumoniae infection. Results Ninety-four cases of mycoplasma pneumoniae and throat swabs from healthy children were detected by quantitative PCR with CARDS-encoding gene as the target gene. The detection rates of Mycoplasma pneumoniae were 71.20% and 15.96% respectively. The positive rate of mycoplasma pneumoniae was 77.6% by passive agglutination test. The positive rate of seropositive mycoplasma pneumoniae was detected by the single detection of serum specific antibody titers ≥1: 160 or four times higher than the double serum antibody titer. The detection rate of mycoplasma pneumoniae infection by fluorescence quantitative PCR with CARDS gene was 80.85% and the sensitivity was 83.56%. The sensitivity and coincidence rate were 71.43% and the specificity was low. Youden index was 0.55, the area under the ROC curve was 0.696, suggesting that the diagnosis of Mycoplasma pneumoniae infection with a certain accuracy. Conclusion The detection of Mycoplasma pneumoniae with fluorescent quantitative PCR with CARDS gene as the target gene is of certain accuracy, rapidness and sensitivity. It is of reference value for the early diagnosis of Mycoplasma pneumoniae. Due to the healthy carrying and the specificity of Mycoplasma pneumoniae, Diagnosis of Mycoplasma pneumoniae infection should be combined with serological and clinical.
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