被动凝集法、间接免疫荧光法和胶体金法联合检测肺炎 支原体抗体对儿童肺炎支原体感染的诊断价值

目的 分析被动凝集法（PA）、间接免疫荧光法（IFA）和胶体金法（GICT）联合检测对儿童肺炎支原体（MP） 感染的诊断价值。方法 选取进行MP抗体检测的患儿617例，以临床诊断为判断标准，分为MP感染组（345例）和 非MP感染组（272例）。所有患儿均经PA检测MP总抗体，经IFA和GICT检测MP-IgM抗体。分析PA、IFA和GICT 这3种方法单独检测及两两联合检测与临床诊断的一致性，受试者工作特征（ROC）曲线评价其对MP感染的诊断价 值，分析PA联合IFA检测2组患儿抗体情况。结果 MP感染组PA检测MP总抗体、IFA和GICT检测MP-IgM抗体的 阳性率较非MP感染组高（P＜0.01）。PA检测MP总抗体的阳性检出率高于IFA和GICT检测MP-IgM抗体的阳性检 出率（P＜0.01）。PA联合IFA与临床诊断为中度一致（Kappa值=0.41，P＜0.05）。3种方法单独检测和两两组合检测 中PA联合IFA的曲线下面积、敏感度、总符合率、阴性预测值最高，阴性似然比最低。GICT单独检测特异度最高。 IFA 单独检测阳性预测值和阳性似然比最高。当 MP-IgM 抗体阳性时，MP 感染组 23.44% 的患儿总抗体滴度＜1︰ 160，非MP感染组47.22%的患儿总抗体滴度≥1︰160。当MP-IgM抗体阴性时，MP感染组91.91%的患儿MP总抗体 滴度≥1︰160，非MP感染组有73.50%的患儿总抗体滴度＜1︰160。结论 PA和IFA联合检测可为临床诊断儿童MP 感染提供更客观、准确的检测结果。

Diagnostic value of particle agglutination,indirect immunofluorescence assay and immune colloidal gold technique combined detection for Mycoplasma pneumoniae antibody in children with Mycoplasma pneumoniae infection

Objective To analyze the diagnostic value of particle agglutination (PA), indirect immunofluorescence assay (IFA) and immune colloidal gold technique (GICT) combined detection for Mycoplasma pneumoniae (MP) infection in children. Methods A total of 617 children were selected for MP antibody detection, and children were divided into the MP infection group (345 cases) and the non-MP infection group (272 cases) based on clinical diagnosis. All the children were detected MP total antibody by PA, and MP-IgM antibody by IFA and GICT. The consistency of PA, IFA and GICT detection alone or in combination with clinical diagnosis was analyzed. The diagnostic value of receiver operating characteristic (ROC) curve in the diagnosis of MP infection was evaluated, and the antibody detection of PA combined with IFA was analyzed. Results The positive rate of total MP antibody detected by PA and MP-IgM antibody detected by IFA and GICT was higher in the MP infected group than those in the non-MP infected group (P＜0.01). The positive rate of total MP antibody detected by PA was significantly higher than MP-IgM antibody detected by IFA and GICT (P＜0.01). PA combined with IFA was moderately consistent with clinical diagnosis (Kappa =0.41, P＜0.05). The area under the curve of the diagnostic value, sensitivity, total coincidence rate and negative predictive value of PA combined with IFA were the highest and the negative likelihood ratio was the lowest. GICT alone had the highest specificity. The positive predictive value and positive likelihood ratio of IFA were the highest. When MP-IgM antibody was positive, the titer of total antibody was＜1︰160 in 23.44% of the MP-infected group and ≥1︰160 in 47.22% of the non-MP-infected group. When MP-IgM antibody was negative, the total antibody titer of MP was≥1︰160 in 91.91% of children in the MP-infected group and ＜1︰160 in 73.50% of children in the non-MP-infected group. Conclusion PA and IFA combined detection can provide more objective and accurate detection results for the clinical diagnosis of MP infection in children.