两种不同方法检测儿童肺炎支原体感染的对比分析

摘要

Objective To compare the serum Mycoplasma pneumoniae antibody ELISA test with indi-rect blood coagulation test method,and to explore the high cost-effective method in laboratory diagnosis of Mycoplasma pneumoniae infection.Methods Totally 352 cases of bronchial pneumonia in children hospital-ized in Department of Paediatrics of Children's Hospital of Hunan Province from December 2013 to January 201 5 were included,and respiratory secretions and serum were made ELISA and indirect hemagglutination test,and serum was isolated and cultured.The separate culture was regarded as the gold standard for the detection.ELISA and indirect hemagglutination test were compared on diagnosis effect.Results The sensi-tivity of indirect hemagglutination test method was 97.5% (1 59/1 63 ),significantly higher than that of ELISA(86.5%,141/1 63)(P <0.05);The specificity of ELISA method for the detection was 91.5%(1 73/189),significantly higher than indirect hemagglutination method(70.9%,134/189 ),the difference being statistically significant(P <0.05 ).The diagnostic efficiency of ELISA detection method was 89.2%,the Kappa index being 0.782;the diagnostic efficiency of indirect hemagglutination method was 83.2%,and the Kappa index was 0.670.The diagnostic efficiency of the two methods was similar,and the Kappa index was in a high degree of consistency.Conclusion ELISA test and indirect blood coagulation test method have their own advantage,so the laboratory can choose the appropriate method according to the clinical diagnosis.%目的：比较血清肺炎支原体抗体 ELISA 检测和间接血凝试验法，探讨肺炎支原体感染实验室诊断的高性价比方法。方法2013年12月至2015年1月湖南省儿童医院儿科收治住院的支气管肺炎患儿352例，取患儿呼吸道分泌物及血清进行 ELISA 检测和间接血凝试验，并且对血清进行分离培养，以分离培养作为检测的金标准，比较 ELISA 检测和间接血凝试验的诊断效果。结果间接血凝实验法的灵敏度为97.5%(159／163)，显著高于 ELISA 检测法86.5%(141／163)，差异有统计学意义(P <0.05)；ELISA 检测法的特异度为91.5%(173／189)，显著高于间接血凝法70.9%(134／189)，差异有统计学意义(P <0.05)。ELISA 检测法诊断效率为89.2%，Kappa 指数为0.782，间接血凝试验法诊断效率为83.2%， Kappa 指数为0.670。两组方法诊断效率相近，Kappa 指数呈中高度一致。结论ELISA 检测和间接血凝实验法各有优势，实验室可按照临床诊断要求选择合适的方法进行检测。