鼻咽抽吸物MP-DNA拷贝数与肺炎支原体肺炎临床表现的关系

doi:10.3969/j.issn.1000-3606.2019.02.001

临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (2): 81-.doi: 10.3969/j.issn.1000-3606.2019.02.001

• 呼吸系统疾病专栏 • 下一篇

鼻咽抽吸物MP-DNA拷贝数与肺炎支原体肺炎临床表现的关系

万姣 1.2，　江李莉 1.2，　索风涛 1.2，　唐琳 1.2，　李媛媛 1.2，　田小银 1，　张光莉 1，　罗征秀 1

1.重庆医科大学附属儿童医院呼吸科；2.儿童发育疾病研究教育部重点实验室儿童发育重大疾病国家国际科技合作基地　儿科学重庆市重点实验室（重庆　400014）

出版日期:2019-02-15 发布日期:2019-02-26
通讯作者: 罗征秀　电子信箱： luozhengxiu816@163.com
基金资助:
国家临床重点专科建设项目（No.2011-873）

Investigation of nasopharyngeal Mycoplasma pneumoniae- DNA copies and clinical characteristics in childhood Mycoplasma pneumoniae pneumonia

WAN Jiao1,2，JIANG Lili1,2，SUO Fengtao1,2，TANG Lin1,2，LI Yuanyuan1,2，TIAN Xiaoyin1，ZHANG Guangli1，LUO Zhengxiu1

1.Department of Respiration, Children’s Hospital of Chongqing Medical University， 2.International Science and Technology Cooperation Base of Child Development and Critical Disorders，Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China

Online:2019-02-15 Published:2019-02-26

摘要/Abstract

摘要： 目的　探讨鼻咽抽吸物肺炎支原体基因MP-DNA拷贝数与肺炎支原体肺炎（MPP）临床表现的关系。方法回顾分析294例MPP住院患儿的临床资料，根据其MP-DNA拷贝数分为低拷贝组（MP-DNA拷贝数≤103/mL）21例、中拷贝组（104~106/mL）156例、高拷贝组（>106/mL）117例。对三组患儿的临床表现、实验室检查结果、胸部X线变化进行比较分析；并用ROC曲线分析鼻咽抽吸物MP-DNA拷贝数对难治性肺炎支原体肺炎（RMPP）的诊断价值。结果　与低、中拷贝组相比，高拷贝组的热程延长，热峰、 C反应蛋白、乳酸脱氢酶增高，大片肺实变或肺不张、胸腔积液、肺外多器官受累以及RMPP发生率也增高，差异均有统计学意义（P<0.05）。MP-DNA拷贝数判断RMPP的ROC曲线下面积（AUC）为 0.701；当临界值为4.83×106时，灵敏度和特异度分别为80.8%和55.4%。结论　鼻咽抽吸物MP-DNA拷贝数与MPP 炎症反应及肺内外损害可能相关，高MP-DNA拷贝数对早期诊断RMPP有一定参考意义。

关键词: 肺炎支原体肺炎；　MP-DNA拷贝数；　鼻炎抽吸物；　儿童

Abstract: Objective　To explore relationship between nasopharyngeal Mycoplasma pneumoniae (MP) -DNA copies and clinical characteristics in Mycoplasma pneumoniae pneumonia (MPP) children. Method　A total of 294 hospitalized MPP children were enrolled retrospectively and grouped according to the levels of nasopharyngeal MP-DNA copies tested: low copy level group (≤103/mL, n=21), moderate copy level group (104-106/mL, n=156) and high copy level group (>106/mL, n=117). Clinical manifestations, laboratory results and image features of the three groups were compared. ROC curve was used to analyze the predictive value of MP-DNA copies in refractory Mycoplasma pneumoniae pneumonia (RMPP). Results　Compared with low and moderate MP-DNA copies groups, high MP-DNA copies group had longer duration of fever, higher peak temperature and CRP level. The incidence of consolidation or atelectasis, pleural effusion, multiple extrapulmonary complications and RMPP were significantly higher in high MP-DNA copies group than those in low/moderate groups. ROC curve analysis showed AUC of the MP-DNA copies for the diagnosis of RMPP was 0.701. The best threshold value estimated was 4.83×106/mL, the diagnostic sensitivity and specificity was 80.8% and 55.4%, respectively. Conclusions　There may be positive correlation between nasopharyngeal MP-DNA copies and inflammation, pulmonary and extrapulmonary damage in MPP children. High MP-DNA copies may serve as a clinical indicator for early diagnosis of RMPP.

Key words: Mycoplasma pneumoniae pneumonia;　MP-DNA copies;　nasopharyngeal;　child

万姣，江李莉，索风涛，等. 鼻咽抽吸物MP-DNA拷贝数与肺炎支原体肺炎临床表现的关系[J]. 临床儿科杂志, 2019, 37(2): 81-.

WAN Jiao, JIANG Lili, SUO Fengtao, et al. Investigation of nasopharyngeal Mycoplasma pneumoniae- DNA copies and clinical characteristics in childhood Mycoplasma pneumoniae pneumonia[J]. Journal of Clinical Pediatrics, 2019, 37(2): 81-.

鼻咽抽吸物MP-DNA拷贝数与肺炎支原体肺炎临床表现的关系

Investigation of nasopharyngeal Mycoplasma pneumoniae- DNA copies and clinical characteristics in childhood Mycoplasma pneumoniae pneumonia

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