鉴别诊断临床急性肺炎病原体感染的血清标志物研究

目的 检测急性肺炎患者血清相关生物标志物含量，为建立一种快速鉴别诊断临床急性支原体肺炎、病毒性肺炎、细菌性肺炎的免疫胶体金检测法提供实验依据。方法 以临床病原学诊断明确的急性支原体肺炎，病毒性肺炎，细菌性肺炎患者和正常人血清为检测样品，采用血小板衍生生长因子（platelet-derived growth factor，PDGF）/杀菌渗透增强蛋白（bactericidal/permeability-increasing protein，BPI）酶联免疫法（enzyme-linked immunosorbent assay，ELISA）检测试剂盒检测上述血清中相关生物标志物含量。结果 （1）正常人群血清78份，急性支原体肺炎患者血清46份，病毒性肺炎和细菌性肺炎患者血清42份，其中病毒感者患者血清35份，细菌感染患者血清7份；（2）正常人群血清PDGF最大值<6 000 pg/mL；血清BPI最大值<80 ng/mL；（3）以血清PDGF值6 000 pg/mL作为鉴别诊断急性支原体感染的基线值，支原体感染患者阳性检出率为93.47%（43/46）；病毒和细菌感染患者出现支原体感染的假阳性率为7.14%（3/42）；（4）以血清BPI值80 ng/mL作为鉴别诊断急性细菌感染的基线值，细菌感染患者阳性检出率为85.71%（6/7）；病毒感染患者出现细菌感染的假阳性率为3.22%（1/31）。结论 以血清PDGF 6 000 pg/mL和BPI 80 ng/mL作为鉴别诊断不同病原体感染的基线值，对临床急性支原体肺炎、病毒性肺炎、细菌性肺炎鉴别诊断具有一定意义。

Studies of serum biomarkers to differentiate and diagnose acute pneumonia pathogens infection

Objective To provide the experimental basis of a rapid immune colloidal gold test which used to differentiate and diagnose acute pneumonia patients infected with mycoplasma pneumoniae(MP)/virus/bacteria. Methods The level of platelet-derived growth factor (PDGF) and bactericidal/permeability-increasing protein (BPI) in the serum of acute pneumonia patients with definite infection of mycoplasma pneumoniae/virus/bacteria and healthy controls were measured by enzyme-linked immunosorbent assay (ELISA) method. Results There were 78 serum samples from healthy controls, 46 from acute MP patients, 42 from acute bacterial and viral pneumonia patients (7 from bacterial pneumonia and 35 from viral pneumonia patients). (2) PDGF values of healthy controls were all less than 6 000 pg/mL; BPI values were all less than 80 ng/mL. (3) If definition of the baseline value of PDGF which could diagnose acute MP infection is as 6 000 pg/mL, the positive detection rate of MP pneumonia patients was 93.47% (43/46), and the MP false positive rate of patients with viral or bacterial pneumonia was 7.14% (3/42). (4) If definition of the baseline value of BPI which could diagnose acute bacterial infection is 80ng/mL, the positive detection rate of patients with bacterial pneumonia was 85.71% (6/7), and the bacteria false positive rate of viral pneumonia patients was 3.22% (1/31). Conclusion Using PDGF's baseline value as 6 000 pg/mL and BPI's 80 ng/mL to differential diagnosis has some clinical significance to differentiate acute MP/virus/bacterium infection.