MP-DNA、MP-IgM及MP-IgG在儿童肺炎支原体感染中的动态变化

目的探讨MP—DNA、MP—IgM及MP—IgG在儿童肺炎支原体感染中的动态变化情况，为患儿的诊治提供依据。方法98例患儿均留取咽拭子和血清标本，采用实时荧光PCR检测患儿咽拭子标本中的MP—DNA；采用颗粒凝集法检测患儿血清中MP—IgM；采用ELISA检测患儿血清中MP—IgG。MP—DNA阳性或MP—IgM阳性或两者都是阳性者均确诊为肺炎支原体感染病例，观察分析确诊病例在不同病程时MP—DNA、MP—IgM及MP—IgG的动态变化规律。结果98例患儿在就诊当天MP—DAN的阳性率达76．53％，随着病程的延长，MP—DNA阳性率逐渐下降；MP—IgM的阳性率在就诊当天为36．73％，大约2周时达高峰，后缓慢下降；MP—IgG在就诊当天的阳性率很低，只有3．06％，大约4周时达高峰，至第8周时仍持续高值，三者在不同病程时期的检出阳性率差异有统计学意义（P〈0．01），且在就诊当天、治疗后1、2、4及8周时差异均有统计学意义（P〈0．01）。结论在肺炎支原体感染患儿不同的病程时期应动态监测MP—DAN、MP—IgM及MP—IgG，并进行综合分析，实现优势互补，以提高诊断的特异度和灵敏度，减少漏诊和误诊，使患者得到早期正确的诊断及治疗。

Dynamic changes of MP-DNA,MP-IgM and MP-IgG in children with Mycoplasma pneumoniae infection

Objective To explore the dynamic changes of MP-DNA,MP-IgM and MP-IgG in children with Mycoplasma pneumoniae infection. Methods Throat swabs and serum samples were taken from the 98 cases of children,MP-DNA in throat swabs was detected by real time fluorescence PCR,serum MP-IgM was detected by pellet agglutination assay, serum MP-IgG was detected by ELISA.Children with positive MP-DNA or MP-IgM alone or both MP-DNA and MP- IgM were all diagnosed as Mycoplasma pneumoniae infection,the changes in the positive rates of MP-DNA,MP-IgM and MP-IgG during different courses were observed and analyzed. Results In the early disease course,The positive rate of MP-DAN was up to 76.53%,and the positive rate of MP-DAN was gradually decreased with the prolongation of the disease.The positive rate of MP-IgM was 36.73% in the early disease course ,about 2 weeks up to peak,then decreased slowly.In the early disease course,the positive rate of MP-IgG was very slow,which was only 3.06%,and then it reached the peak after 4 weeks of the treatent,and continued high value until to eight weeks,the differences of the positive rate of MP-DAN,MP-IgM and MP-IgG during different course were all statistically significant （P〈0.01）,and there were sta- tistical differences in the early disease course,second week,fourth weeks and eighth weeks（P〈0.01）. Conclusion In dif- ferent periods of children with Mycoplasma pneumoniae infection,the dynamic monitoring of MP-DAN,MP IgM and MP-IgG should be taken,and gives synthetically analysis,complement each other in order to improve the diagnostic sensitivity and specificity,and reduce missed diagnosis and misdiagnosis,make the patients get early correct diagnosis and treatment.