血清超敏C反应蛋白、免疫球蛋白及肺炎支原体DNA对小儿支原体肺炎的诊断价值(1)
[摘要]目的 探讨血清超敏C反应蛋白(hs-CRP)、免疫球蛋白及肺炎支原体DNA(MP-DNA)对小儿支原体肺炎(MPP)的诊断价值。方法 选择自2013年1月～2016年1月我院儿科住院并确诊为MPP的120例患儿为MPP组；同期选择我院门诊30名健康体检小儿作为对照组；检测并比较两组患儿血清hs-CRP、免疫球蛋白(IgA、IgG、IgM等)及MP-DNA水平。结果 MPP组患儿的hs-CRP及MP-DNA水平明显高于对照组，差异有统计学意义(P<0.05)；MPP组IgA、IgG及IgM水平均低于对照组，差异有统计学意义(P<0.05)。ROC曲线示，hs-CRP曲线下面积为0.776，在最佳阈值8.18 mg/L时，其诊断MPP的敏感度为0.724，特异度为0.862；IgA+IgG+IgM联合检测时曲线下面积为0.778，在最佳阈值2.68 mg/L时，其诊断MPP的敏感度为0.808，特异度为0.694；MP-DNA曲线下面积为0.751，在最佳阈值7.56×105 copy/ml时，其诊断MPP的敏感度为0.769，特异度为0.781。结论 hs-CRP、免疫球蛋白及MP-DNA水平联合检测对MPP具有较高的早期诊断价值。
[关键词]超敏C反应蛋白；免疫球蛋白；肺炎支原体DNA；小儿支原体肺炎
[中图分类号] R725.6 [文献标识码] A [文章编号] 1674-4721(2017)03(a)-0115-03
[Abstract]Objective To investigate the value of serum high-sensitivity C reactive protein (hs-CRP)，immunoglobulin and Mycoplasma Pneumoniae DNA (MP-DNA) in diagnosis of children with Mycoplasma pneumonia (MPP).Methods Altogether 120 children confirmedly diagnosed with MPP who were hospitalized from January 2013 to January 2016 in department of pediatrics in our hospital were selected as MPP group；30 healthy children who were treated in department of outpatient in our hospital at the same period of time were selected as control group；the levels of serum hs-CRP，immunoglobulin (IgA，IgG，IgM etc.) and MP-DNA of the two groups were detected and compared.Results The levels of hs-CRP and MP-DNA of patients in MPP group were higher than those in control group，with statistically significant difference (P<0.05)；the levels of IgA，IgG and IgM of child patients in MPP group were lower than those in control group，with statistically significant difference (P<0.05).The ROC curve showed the area under hs-CRP curve was 0.776，when the optimal threshold value was 8.18 mg/L，the sensitivity and specificity in diagnosis of MPP were 0.724 and 0.862；as for the combined detection of IgA+IgG+IgM，the area under curve was 0.778，the optimal threshold was 2.68 mg/L，the diagnostic sensitivity and specificity of MPP were 0.808 and 0.694；the area under the MP-DNA curve was 0.751，the optimal threshold was 7.56×105 copy/mL，the diagnostic sensitivity and specificity of MPP were 0.769 and 0.781.Conclusion Combination application of hs-CRP，immunoglobulin and MP-DNA in detection of patients with MPP is of high value in early diagnosis.
[Key words]High-sensitivity C reactive protein；Immunoglobulin；Mycoplasma Pneumoniae DNA；Mycoplasma pneumonia in children
小兒支原体肺炎(Mycoplasma pneumonia，MPP)是儿科常见的呼吸系统疾病之一，近年来其发病率呈逐年上升趋势。MPP主要是由肺炎支原体(Mycoplasma Pneumoniae，MP)感染引起的一种呼吸道疾病，临床表现主要以剧烈咳嗽为主，常伴有咽痛、头痛等不适。MP感染除了呼吸系统症状外，随着病程进展可侵犯肺外组织，如心肌及肾脏等，严重时因多器官功能衰竭而致患儿死亡[1-3]，故对MPP进行早期诊断及治疗显得尤为重要[4]。本研究旨在探讨血清超敏C反应蛋白(hs-CRP)、免疫球蛋白(IgA、IgG、IgM等)及MP-DNA对MPP的诊断价值，以进行早期诊断和治疗，改善患儿预后，现报道如下。 (郭瑞雪)
[关键词]超敏C反应蛋白；免疫球蛋白；肺炎支原体DNA；小儿支原体肺炎
[中图分类号] R725.6 [文献标识码] A [文章编号] 1674-4721(2017)03(a)-0115-03
[Abstract]Objective To investigate the value of serum high-sensitivity C reactive protein (hs-CRP)，immunoglobulin and Mycoplasma Pneumoniae DNA (MP-DNA) in diagnosis of children with Mycoplasma pneumonia (MPP).Methods Altogether 120 children confirmedly diagnosed with MPP who were hospitalized from January 2013 to January 2016 in department of pediatrics in our hospital were selected as MPP group；30 healthy children who were treated in department of outpatient in our hospital at the same period of time were selected as control group；the levels of serum hs-CRP，immunoglobulin (IgA，IgG，IgM etc.) and MP-DNA of the two groups were detected and compared.Results The levels of hs-CRP and MP-DNA of patients in MPP group were higher than those in control group，with statistically significant difference (P<0.05)；the levels of IgA，IgG and IgM of child patients in MPP group were lower than those in control group，with statistically significant difference (P<0.05).The ROC curve showed the area under hs-CRP curve was 0.776，when the optimal threshold value was 8.18 mg/L，the sensitivity and specificity in diagnosis of MPP were 0.724 and 0.862；as for the combined detection of IgA+IgG+IgM，the area under curve was 0.778，the optimal threshold was 2.68 mg/L，the diagnostic sensitivity and specificity of MPP were 0.808 and 0.694；the area under the MP-DNA curve was 0.751，the optimal threshold was 7.56×105 copy/mL，the diagnostic sensitivity and specificity of MPP were 0.769 and 0.781.Conclusion Combination application of hs-CRP，immunoglobulin and MP-DNA in detection of patients with MPP is of high value in early diagnosis.
[Key words]High-sensitivity C reactive protein；Immunoglobulin；Mycoplasma Pneumoniae DNA；Mycoplasma pneumonia in children
小兒支原体肺炎(Mycoplasma pneumonia，MPP)是儿科常见的呼吸系统疾病之一，近年来其发病率呈逐年上升趋势。MPP主要是由肺炎支原体(Mycoplasma Pneumoniae，MP)感染引起的一种呼吸道疾病，临床表现主要以剧烈咳嗽为主，常伴有咽痛、头痛等不适。MP感染除了呼吸系统症状外，随着病程进展可侵犯肺外组织，如心肌及肾脏等，严重时因多器官功能衰竭而致患儿死亡[1-3]，故对MPP进行早期诊断及治疗显得尤为重要[4]。本研究旨在探讨血清超敏C反应蛋白(hs-CRP)、免疫球蛋白(IgA、IgG、IgM等)及MP-DNA对MPP的诊断价值，以进行早期诊断和治疗，改善患儿预后，现报道如下。 (郭瑞雪)