两种肺炎支原体抗体检测方法的临床应用研究

目的 探讨两种实验室检测方法-被动颗粒凝集法（凝集法）和ELISA法检测在肺炎支原体（Mycoplasma pneumonia,MP）诊断中的临床应用价值.方法 选择191份MP感染疑似患者血清,采用凝集法检测各样本中MP抗体的水平,同时采用ELISA法对各样本中的MP IgM、IgA、IgG特异性抗体进行分型检测,并对检测结果进行统计学分析.结果 两种方法检测结果的阳性符合率为88.4％,阴性符合率为75.8％,总符合率为84.3％.两种方法检测结果一致性Kappa=0.642（P=0.001）,且检测结果存在相关性（r=0.642,P=0.025）.随着凝集法中抗体滴度由低到高,IgM、IgA亚型阳性的样本比例增加,且各滴度组间的比例差异均有统计学意义（P均＜ 0.05）.凝集法阳性样本中既往感染比例为26.4％,现症感染率为58.1％.特异性IgM抗体在幼儿组（43.3％）及青少年组（36.1％）患者中检出率最高,而IgG（100.0％）及IgA（66.7％）在老年组患者中检出率最高.结论 凝集法与ELISA法检测结果的符合性较好;较之凝集法,ELISA法检测IgM、IgA、IgG亚型可提示病程,区分现症感染和既往感染,对不同年龄段MP感染都具有诊断价值.建议同时参考抗体各亚型的检测结果来确定现症感染.

The clinical application research of two methods in detecting Mycoplasma pneumonia antibody

Objective To investigate the diagnostic value of both passive particle agglutination （PPA） test and enzyme-linked immunosorbent assay （ELISA） on Mycoplasmapneumonia （MP） infection. Methods 191 patients with respiratory symptoms were selected. The level of MP antibody was detected by PPA method, and the levels of MP specific antibody including IgM, IgA and IgG were detected by ELISA method. The results were analyzed statistically. Results The positive coincidence rate between PPA and ELISA was 88.4%, and negative coincidence rate was 75.8%, and total coincidence rate was 84.3%. The results of concordance for two methods was Kappa= 0.642 （P= 0.001）, and there was correlation between the results of two methods （r= 0.642, P= 0.025 ）. The sample proportion with IgM,IgA positive increased along with the upgrade of antibody titer, and there were all had statistical significance in the differences of proportion among different titer groups （Pall〈 0.05）. In PPA positive sample, the past infection proportion was 26.4%, and the current infection proportion was 58.1%. The prevalence of MP IgM antibody was the highest in the children group （43.3%） and teenager group （36.1%）, while the elder group had a relatively higher percentage in IgG （100.0%） and IgA （66.7%） antibody. Conclusion The concordance between PPA and ELISA is good for MP antibody detection. ELISA method can detect antibody isoforrn which can indicate disease progression, thus to discriminate current infection from past, and can have important diagnostic role for infection in different ages. It is suggested that antibody isoform detecting is critical for confirmation of a current MP infection.