Comparison in values of ratio of monocyte to neutrophil, particle agglutination method, and colloidal gold method in the diagnosis of children with mycoplasma pneumoniae infection
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摘要: 目的 比较单核细胞/中性粒细胞(MONO/NEUT)指标检测、颗粒凝集法检测肺炎支原体(MP)抗体、胶体金法检测肺炎支原体IgM抗体(MP-IgM)对儿童MP感染的诊断价值。 方法 选取高度符合儿童MP感染典型症状的患儿100例作为研究对象,均采用颗粒凝集法检测MP抗体,并采用胶体金法检测MP-IgM。统计颗粒凝集法、胶体金法对不同病程、不同年龄段患儿的阳性检出率,以快速培养鉴定镜检法为“金标准”,比较颗粒凝集法、胶体金法的灵敏度、特异度和准确度,并分析MONO/NEUT指标与MP感染的相关性。 结果 100例患儿中, 68例患儿经“金标准”确诊MP阳性; 相同病程患儿中, 2种检测方法的阳性检出率比较,差异无统计学意义(P>0.05); 2种方法对病程≥7 d患儿的阳性检出率均高于病程<7 d的患儿,差异有统计学意义(P<0.05); 相同年龄段患儿中, 2种检测方法的阳性检出率比较,差异无统计学意义(P>0.05); 2种方法对7~14岁患儿的阳性检出率均高于60 d~6岁患儿,差异有统计学意义(P<0.05); 68例MP阳性患儿中,颗粒凝集法的阳性检出率为86.76%(59/68), 胶体金法为89.71%(61/68), 差异无统计学意义(P>0.05); 2种检测方法的灵敏度、特异度和准确度比较,差异均无统计学意义(P>0.05); MP阳性组患儿MONO/NEUT指标水平升高率高于MP阴性组,差异有统计学意义(P<0.01); Kendall's tau-b等级相关性检验结果显示, MONO/NEUT指标水平与MP阳性结果呈正相关(r=0.565, P<0.001)。 结论 对于儿童MP感染,胶体金法检测MP-IgM可获得与颗粒凝集法检测MP抗体相似的临床诊断结果,且操作方法更简单,耗时更少,对检测人员的专业素质要求更低,而MONO/NEUT指标水平与MP阳性结果呈显著正相关,故推荐将胶体金法联合MONO/NEUT指标检测应用于MP感染的临床诊断中,以获得更优的诊断效能。
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关键词:
- 肺炎支原体 /
- 感染 /
- 单核细胞/中性粒细胞 /
- 胶体金法 /
- 颗粒凝集法
Abstract: Objective To compare ratio of monocyte to neutrophil(MONO/NEUT), the particle agglutination method in detection of mycoplasma pneumoniae(MP)and colloidal gold method in detection of MP immunoglobulin M(MP-IgM)in the diagnosis of children with MP infection. Methods A total of 100 children with highly similar typical symptoms of MP infection were selected as research objects, and were detected by particle agglutination method for MP antibody, and by colloidal gold method for MP-IgM. The positive rates of particle agglutination method and colloidal gold method in children with different disease courses and ages were analyzed. Taking rapid cultivation microscopic examination as gold criteria, the sensitivity, specificity and accuracy of particle agglutination method and colloidal gold method were compared, and correlation between MONO/NEUT ratio and MP infection was analyzed. Results Out of 100 children, 68 cases were confirmed as positive MP. For those with the same course of disease and age, no significant difference was found in two methods(P>0.05). The positive rates of children with course of disease ≥7 d were significantly higher than those with course - of disease <7 d(P<0.05). There was no significant difference in positive rate between two methods in children with the same age(P>0.05). Compared with the children aged 60 days to 6 years, the positive rates of two methods in the children aged 7 to 14 years were higher(P<0.05). Among the 68 children with positive MP, the positive detection rate of particle agglutination method and colloidal gold method were 86.76%(59/68)and 89.71%(61/68)respectively, and there was no statistical difference between the two methods(P>0.05). There were no statistical differences in the sensitivity, specificity, accuracy between particle agglutination method and colloidal gold method(P>0.05). The increase rate of MONO/NEUT level in MP positive group was higher than that in MP negative group, and the difference was statistically significant(P<0.01). Kendall's tau-b grade correlation test results showed that the MONO/NEUT level was positively correlated with the positive MP results(r=0.565, P<0.001). Conclusion The colloidal gold method can obtain similar clinical results as the particle agglutination method for MP antibody detection in diagnosis of MP infection in children. Moreover, it is simple in operation, less time-consuming and requires lower professional quality of the detection personnel. Because MONO/NEUT level is positively correlated with the positive MP results, colloidal gold method combined with MONO/NEUT detection is recommended to obtain a better efficacy in diagnosis of MP in clinic. -
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