社区获得性肺炎支原体肺炎儿童血清抗体滴度的变化

摘要

Objective To study the variation of serum Mycoplasma pneumoniae (MP) antibody in children with community-acquired Mycoplasma pneumoniae pneumonia(CA-MPP),and to explore its early diagnostic value in MPP.Methods A retrospective analysis of case series was performed in 134 children with CA-MPP.The 134 children were admitted and diagnosed as CA-MPP at Department of Pediatrics,the Affiliated Hospital of Qingdao University between January 2013 and December 2014,among whom 56 cases were male and 78 cases were female(the ratio of boys to girls was 1.00 ∶ 1.39).The children aged from 6 months to 14 years old with a course of 8-23 days.Particle agglutination was used to detect serum MP antibody,and the changes in the titers were analyzed during 4-21 days of first onset.Results The positive cases of serum antibody(≥ 1 ∶ 160) during 4-7 days,8-14 days,15-21 days of first onset was 33/70 cases,131/143 cases,65/65 cases,and the positive rate was 41.7％,91.6％ and 100.0％,respectively.Serum MP antibody titers during 4-21 days of first onset were positively correlated with the duration(r =0.832,P =0.000).Seventy-five (88.24％) patients in 85 CA-MPP children diagnosed by paired serum test (an interval of 2 weeks) had a fourfold or greater increase after the onset of 1 week.Conclusions Serum MP antibody titer is closely related to the duration of children with MP infection after the onset of disease.The result also suggested that retesting the antibody titer interval for 1 week may have more diagnostic value in diagnosing MP infection than after an interval of 2 weeks.%目的 研究儿童社区获得性肺炎支原体肺炎(CA-MPP)血清肺炎支原体(MP)抗体滴度的变化规律,探讨其在MPP中的诊断价值.方法 以2013年1月至2014年12月青岛大学附属医院儿科确诊的134例CA-MPP住院患儿为研究对象.其中男56例,女78例,男女比例为1.00:1.39;年龄6个月～14岁;病程8～23 d.采用颗粒凝集法对134例CA-MPP患儿进行血清MP抗体滴度检测,分析发病4～21 d血清MP抗体滴度的变化规律,对结果进行统计学分析.结果 1.在病程4～7d、8～14d、15～21 d,134例CA-MPP患儿MP抗体滴度≥1:160份数分别为33/70份、131/143份、65/65份,阳性率分别为41.7％、91.6％、100.0％.2.患儿在病程4～21 d,血清MP抗体滴度与病程呈正相关(r=0.832,P=0.000).3.在85例依靠双份血清(间隔2周)确诊的CA-MPP患儿中,75例(88.24％)1周后复查MP抗体滴度较初诊时升高4倍或4倍以上.结论 CA-MPP患儿血清MP抗体滴度变化与病程密切相关.依靠双份血清MP抗体滴度变化诊断MP感染时不必间隔2周,间隔1周复查对临床有指导意义.