CAJ | 학술논문

目的研究酶联免疫法( ELISA)抗体分型检测与被动颗粒凝集法(凝集法)检测结果间的一致性,并探讨两种检测对肺炎支原体感染的诊断价值.方法 2010年11月至2011年5月间,从济宁医学院附属医院收集191例肺炎支原体感染疑似患者的血清.采用凝集法检测标本中肺炎支原体抗体的滴度水平,ELISA对肺炎支原体IgM、IgG、IgA抗体进行分型检测.Kappa检验评价两种检测结果的一致性,Kruskal-Wallis秩和检验分析各抗体哑型在凝集法滴度组间和患者年龄组间的分布差异.通过抗体分型分析各滴度组标本所处的病程,并结合临床诊断评价凝集法高滴度标本中两种方法检测结果的诊断价值.结果 191例患者中,两种方法对肺炎支原体感染的检测总符合率为84.3％,Kappa =0.642,P＜0.01.凝集法不同滴度组间IgM及IgA的检出率存在统计学差异(P＜0.05).另外,IgM在幼儿及青少年患者中检出率较高,而IgG及IgA在老年患者中检出率较高.抗体分型结果提示,凝集法阳性组中75例(58.1％o)为现症感染,其中高滴度组中27例(96.4％)为现症感染,与该组的临床诊断相符.结论凝集法与ELISA法的一致性较好；ELISA法检测IgM、IgG、IgA亚型可提示现症感染和既往感染.
목적 연구매련면역법( ELISA)항체분형검측여피동과립응집법(응집법)검측결과간적일치성,병탐토량충검측대폐염지원체감염적진단개치.방법 2010년11월지2011년5월간,종제저의학원부속의원수집191례폐염지원체감염의사환자적혈청.채용응집법검측표본중폐염지원체항체적적도수평,ELISA대폐염지원체IgM、IgG、IgA항체진행분형검측.Kappa검험평개량충검측결과적일치성,Kruskal-Wallis질화검험분석각항체아형재응집법적도조간화환자년령조간적분포차이.통과항체분형분석각적도조표본소처적병정,병결합림상진단평개응집법고적도표본중량충방법검측결과적진단개치.결과 191례환자중,량충방법대폐염지원체감염적검측총부합솔위84.3％,Kappa =0.642,P＜0.01.응집법불동적도조간IgM급IgA적검출솔존재통계학차이(P＜0.05).령외,IgM재유인급청소년환자중검출솔교고,이IgG급IgA재노년환자중검출솔교고.항체분형결과제시,응집법양성조중75례(58.1％o)위현증감염,기중고적도조중27례(96.4％)위현증감염,여해조적림상진단상부.결론 응집법여ELISA법적일치성교호；ELISA법검측IgM、IgG、IgA아형가제시현증감염화기왕감염.
Objective To investigate the consistency between the results of passive particle agglutination test ( PPA ) and ELISA on Mycoplasma pneumonia ( M.pneumonia ) infection.Study the diagnostic value of both assays.Methods From November 2010 to May 2011,the serum samples of ]191 patients with respiratory symptoms were collected from Affiliated Hospital of Jining Medical University.All samples were tested for antibody levels against M.pneumonia using PPA,and for IgM,IgG,IgA subclass using ELISA.The correlation between the results of two methods was evaluated by Kappa test and Spearman rank correlation analysis.The variances of the antibody subclasses among samples with different PPA titers and different age groups were analyzed by Kruskal-Wallis test.The infection status of patients was analyzed based on ELISA results and the clinical relevance of both assays was evaluated in comparison with clinical diagnosis for samples with high PPA titer.Results The level of agreement between the results of PPA and ELISA was 84.3％,with Kappa value of 0.642 ( P ＜0.01 ).The prevalence of IgM and IgA antibody against M.pneumonia was significantly different among samples with various PPA titers ( P ＜0.05 ).The prevalence of IgM subclass was higher in chill and teeuager groups,while that of IgA and IgG were higher in elderly group.Antibody isotyping results suggested that 58.1％ of PPA positive samples (75 cases),especially 96.4％ of samples with high PPA titer ( 27 cases),were of current infection,which was in consistent with clinical diagnosis.Conclusion PPA showed good consistency with ELISA on diagnosis of Mycoplasma pneumonia infection.Antibody subclass determination hy ELISA indicates disease progression,thus to differentiate current infection from past.