儿童肺泡灌洗液RT-PCR检测对支原体感染的辅助诊断价值探讨

目的 探讨支原体感染儿童肺泡灌洗液RT-PCR检测的早期诊断和病情评估。方法 选取2016年1月至12月安徽省儿童医院收治的235例感染肺炎支原体（MP）的患儿，检测重症肺炎和轻症肺炎肺泡灌洗液MP-DNA和血清MP-IgM，根据2项指标的差异和MP-DNA拷贝量的高低，分析MP-DNA与病情的关系。结果 男患儿MP-IgM阳性率低于女患儿，>3~14岁患儿MP-DNA阳性率高于1~3岁患儿，入院前病程≤ 7 d患儿MP-IgM阳性率低于入院前病程>7 d患儿，差异有统计学意义（P<0.05）。重症肺炎患儿中，MP-DNA高拷贝量占85.71%，高于轻症肺炎患儿，差异有统计学意义（P<0.05）；重症肺炎的MP-DNA拷贝量高于轻症肺炎患儿，差异有统计学意义（P<0.05）。结论 RT-PCR法检测支原体肺炎患儿肺泡灌洗液MP-DNA拷贝量可为快速确诊和判断患儿病情提供参考。

Analysis of bronchoalveolar lavage fluid MP-DNA detection by RT-PCR for aided diagnosis in children with mycoplasma infection

Objective To evaluate the diagnostic value of real time fluorescence quantitative PCR (RT-PCR) applied in bronchoalveolar lavage fluid MP-DNA detection in children with mycoplasma infection at the early stage. Methods The bronchoalveolar lavage fluid MP-DNA and serum MP-IgM from 235children with mycoplasma pneumoniae were deeply measured,and these indexes were further used to evaluate the relationship with the state of an illness. Results The positive rates of MP-IgM in male were lower than those in female, the positive rates of MP-DNA in >3~14 years old were higher than those in 1~3 years old, the positive rates of MP-IgM in children with a course of diseaseless than and equal to 7 days from onset to hospital admission were significantly lower than those in a course of disease more than 7 days, and the difference was statistically significant (P<0.05). The high-copy MP-DNA accounted for 85.71% in children with severe pneumonia, and the proportions of the high-copy MP-DNA in children with severe pneumonia were higher than those in children with mild pneumonia, and there was a significant statistical difference(P<0.05); the copy numbers of MP-DNA in children with severe pneumonia were higher than those in children with mild pneumonia, and there was a significant statisticaldifference(P<0.05) Conclusion The RT-PCR method to check the copies of bronchoalveolar lavage fluid MP-DNA provides a reference for fast and accurate diagnosis of the severity of children disease.