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目的 了解儿童肺炎衣原体 (C pn)肺炎的发病情况 ,探讨套式聚合酶链反应 (nPCR)及微量免疫荧光 (MIF)检测肺炎衣原体肺炎的临床意义。方法 联合应用nPCR及MIF检测 30 0例肺炎患儿及 130例健康儿童 ,结果进行统计学分析 ,并随机选取 2例nPCR阳性标本 ,进行DNA测序。结果 检测 30 0例肺炎中 ,nPCR阳性且MIF符合急性感染标准者 30例 ,即确诊为肺炎衣原体肺炎 ,占肺炎总数的 10 0 %。nPCR阳性者 42例占 14 0 % ,MIF符合急性感染标准者 31例 ,占 10 3% ,在年龄分布上 ,12 0例≤ 3岁者有 16例nPCR阳性 ,阳性率 13 3% ,8例MIF符合急性感染标准 ,阳性率 6 7% ;180例 >3岁患儿中 2 6例nPCR阳性 ,阳性率 14 4% ,2 3例MIF符合急性感染标准 ,阳性率 12 8%。130例健康对照组儿童中 ,nPCR均呈阴性 ,虽有 2 4例MIFIgG≥ 1∶16 (IgG滴度分别为 1∶16～ 1∶12 8) ,但无一例符合急性感染标准。 2例nPCR阳性标本nPCR产物之DNA序列与C pn标准株 (CWL 2 9)完全一致。结论 肺炎衣原体是儿童肺炎重要的病原 ,nPCR诊断肺炎衣原体感染快速、简便、敏感、特异性高 ,联合应用nPCR及MIF可以提高诊断的敏感性和特异性
Objective To investigate the incidence of pneumonia in children with Chlamydia pneumoniae and to explore the clinical significance of detection of Chlamydia pneumoniae pneumonia by nested polymerase chain reaction (nPCR) and micro-immunofluorescence (MIF). Methods 30 cases of children with pneumonia and 130 healthy children were detected by nPCR and MIF. The results were statistically analyzed. Two cases of nPCR positive samples were randomly selected for DNA sequencing. Results 30 cases of pneumonia, nPCR positive and MIF consistent with the criteria of acute infection in 30 cases, that is diagnosed with pneumoniae pneumonia, accounting for 100% of the total number of pneumonia. nPCR positive 42 cases accounted for 14 0%, MIF 31 cases consistent with acute infection criteria, accounting for 10 3%, in age distribution, 12 0 ≤ 3 years of age were 16 cases of nPCR positive, the positive rate of 13 3%, 8 cases The positive rate of MIF was 67%. The positive rate of nPCR was 14.4% in 180 cases> 3 years old, and the positive rate was 14.4%. The positive rate of MIF was 12.8%. Of the 130 healthy children, nPCR was negative, although 24 cases had MIF IgG ≥ 1:16 (IgG titers were 1:16 to 1:12 8, respectively), none of them met the criteria of acute infection. The DNA sequence of nPCR products from 2 nPCR positive specimens was identical with that of C pn standard strain (CWL 2 9). Conclusion Chlamydia pneumoniae is an important pathogen of pneumonia in children. The diagnosis of Chlamydia pneumoniae infection by nPCR is rapid, simple, sensitive and specific. Combination of nPCR and MIF can improve the sensitivity and specificity of diagnosis