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MSCT联合血清MP-IgM、MP-Ab检测对小儿支原体感染肺炎有较高的诊断价值
作者姓名:李小容  唐川婷  高广川  侯小艳
作者单位:四川大学华西广安医院儿科,四川 广安 638000
基金项目:国家重点研发项目2017YFC0907304
摘    要:  目的  分析多层螺旋CT(MSCT)联合血清肺炎支原体免疫球蛋白M(MP-IgM)、肺炎支原体抗体(MP-Ab)检测对小儿支原体感染肺炎的诊断效能。  方法  选取2019年1月~2021年1月本院收治的86例疑似支原体感染肺炎小儿为研究对象,采用金标准将患者分为感染组(n=38)和非感染组(n=48)。采用MSCT对所有患者进行扫描检查,并检测血清MP-IgM和MP-Ab水平,采用ROC曲线分析MSCT联合血清MP-IgM、MP-Ab对小儿支原体感染肺炎的诊断效能。  结果  MSCT图显示,小儿支原体感染肺炎表现为支气管充气相、支气管壁增厚、磨玻璃影、网状影和支气管血管束增厚,此外还可见明显的呈扇形分布的薄片影。在38例感染患儿中,发生在单侧左肺的有15例(39.47%),发生在单侧右肺的有17例(44.74%),发生在双肺的有6例(15.79%);MSCT与金标准具有较好的一致性(Kappa=0.72);感染组MP-IgM阳性和MP-Ab阳性率均高于非感染组(P < 0.05);根据临床诊断为准制作ROC曲线,其中3项联合的诊断价值最高,其与MSCT、MP-IgM、MP-Ab的差异均有统计学意义(P < 0.05)。  结论  MSCT联合MP-IgM、MP-Ab对支原体感染肺炎小儿具有较高的诊断价值。 

关 键 词:多层螺旋CT    肺炎支原体免疫球蛋白M    肺炎支原体抗体    支原体感染肺炎    诊断效能
收稿时间:2022-02-28

Diagnostic efficacy of multi-slice spiral CT combined with serum MP-IgM and MP-Ab detection in children with mycoplasma pneumonia
Authors:LI Xiaorong  TANG Chuanting  GAO Guangchuan  HOU Xiaoyan
Institution:Department of Pediatrics, West China Guang'an Hospital, Sichuan University, Guang'an 638000, China
Abstract:  Objective  To analyze the diagnostic efficacy of multi-slice spiral CT (MSCT) combined with serum mycoplasma pneumoniae immunoglobulin M (MP- IgM) and mycoplasma pneumoniae antibody (MP-Ab) in children with mycoplasma pneumonia.  Methods  A total of 86 children with suspected mycoplasma pneumonia admitted to our hospital from January 2019 to January 2021 were selected as the study subjects, and divided into the infection group (n=38) and non-infection group (n=48) according to the gold standard. MSCT was used to scan all children, and serum MP-IgM and MP-Ab levels were measured. ROC was used to analyze the diagnostic efficacy of MSCT combined with serum MP-igm and MP-Ab for mycoplasma pneumonia in children.  Results  MSCT images showed that mycoplasma infection pneumonia in children showed bronchial inflation phase, bronchial wall thickening, ground- glass opacities, reticular opacities and bronchovascular bundle thickening. In addition, there were obvious fan-shaped thin slices. Among 38 cases, 15 cases (39.47%) occurred in unilateral left lung, 17 cases (44.74%) in unilateral right lung, and 6 cases (15.79%) in bilateral lung. MSCT had good consistency with gold standard (Kappa=0.72). The positive rates of MP-IgM and MP-Ab in infected group were significantly higher than those in non-infected group (P < 0.05). ROC curve was made based on clinical diagnosis, among which three combinations had the highest diagnostic value, and there were significant differences compared with MSCT, MP-IgM and MP-Ab (P < 0.05).  Conclusion  MSCT combined with MP-IgM and MP-Ab has high diagnostic value in children with mycoplasma pneumonia. 
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