CAJ | 학술논문

目的：通过酶联免疫吸附（ELISA）法抗体分型检测探讨被动凝集法（PA）和间接免疫荧光法（IFA）检测肺炎支原体出现的不一致结果的意义，提高实验室对肺炎支原体的检测及结果解释能力。方法通过 ELISA 法对 PA 法和 IFA法检测结果中出现的不一致的样本进行分型检测（IgG 和 IgM），对所测结果结合临床资料进行对比研究。结果 IFA 和ELISA 在检测 MP - IgM 上存在的方法学差异有统计学意义（182例标本经配对卡方检验得 P ﹤0.05，Kappa =0.294）；PA 法和 ELISA 在不区分抗体分型的情况下两者的阳性检出率差异无统计学意义（ P ﹥0.05，Kappa =0.497）；IFA 阳性、PA 为阴性的组和 PA 为阳性、IFA 为阳性或阴性的两组间类风湿因子（RF）检出差异存在统计学意义（ P ﹤0.01），RF 可能是造成 IFA 法假阳性的一个原因。结论被动凝集法和 IFA 法联合检测均为阳性一致结果的个体和临床治疗符合率极高，但当两者不一致时需结合多方面因素分析，尤其是当 PA 为阴性而 IFA 为阳性的时候。在实验室方面建议将IFA 检测结果分阳性、弱阳性、阴性发出报告，而临床医生处理这种结果需要结合动态监测 PA 结果做出正确诊断。
목적：통과매련면역흡부（ELISA）법항체분형검측탐토피동응집법（PA）화간접면역형광법（IFA）검측폐염지원체출현적불일치결과적의의，제고실험실대폐염지원체적검측급결과해석능력。방법통과 ELISA 법대 PA 법화 IFA법검측결과중출현적불일치적양본진행분형검측（IgG 화 IgM），대소측결과결합림상자료진행대비연구。결과 IFA 화ELISA 재검측 MP - IgM 상존재적방법학차이유통계학의의（182례표본경배대잡방검험득 P ﹤0.05，Kappa =0.294）；PA 법화 ELISA 재불구분항체분형적정황하량자적양성검출솔차이무통계학의의（ P ﹥0.05，Kappa =0.497）；IFA 양성、PA 위음성적조화 PA 위양성、IFA 위양성혹음성적량조간류풍습인자（RF）검출차이존재통계학의의（ P ﹤0.01），RF 가능시조성 IFA 법가양성적일개원인。결론피동응집법화 IFA 법연합검측균위양성일치결과적개체화림상치료부합솔겁고，단당량자불일치시수결합다방면인소분석，우기시당 PA 위음성이 IFA 위양성적시후。재실험실방면건의장IFA 검측결과분양성、약양성、음성발출보고，이림상의생처리저충결과수요결합동태감측 PA 결과주출정학진단。
Objective To investigate the methodological differences between particle agglutination and indirect immunofluorescence as-say. Methods Particle agglutination assay,indirect immunofluorescence assay and enzyme - linked immunosorbent assay were used to examine MP antibodies in the blood sera of 182 children hospitalized suspected MP infections. All these cases were divided into four groups according to the results of PA and IFA. The inconsistent results of PA and IFA were mainly discussed. Results The results of IFA and ELISA showed statistically significant in detecting MP - IgM(182 cases,McNemanr test,P ﹤ 0. 05,Kappa = 0. 294). PA and ELISA's positive rate showed no statistically difference while not typing antibody IgG or IgM(182 cases,McNemanr test,P ﹥ 0. 05,Kappa = 0. 497). Rheumatoid factor(RF)detection rate showed statistical significance difference between IFA positive,PA negative group and PA positive group with the final diagnosis of none Mycoplas-ma infection and mycoplasma infection( P ﹤ 0. 01). RF may be a cause of false positive in IFA detection. Conclusion The consistent results of PA and IFA have an extremely high coincidence with the final clinical diagnosis. But we should combine various factors to analyze the meaning of inconsistent results from PA and IFA,especially when PA is negative and IFA is positive.