【摘要】：目的以血清顆粒凝集試驗(yàn)(particle agglutination test,PA)為標(biāo)準(zhǔn),研究肺炎支原體(MP)液體培養(yǎng)法檢測(cè)結(jié)果的實(shí)驗(yàn)診斷學(xué)價(jià)值,并探索液體培養(yǎng)法的優(yōu)化方法。方法 2014年5月至2014年9月從我院收集2991例檢查患者,采用液體培養(yǎng)法對(duì)患者咽拭子標(biāo)本進(jìn)行MP檢測(cè),得到結(jié)果(liquid culture,LC)1。將液體培養(yǎng)法陽性液采用平板分離培養(yǎng),鑒定培養(yǎng)出的細(xì)菌后與其標(biāo)準(zhǔn)菌株定量接種于MP液體培養(yǎng)基,判斷污染可能性,篩除假陽性后得到LC2。PA法檢測(cè)同一患者血清中肺炎支原體的滴度。與PA比較,采用三維配對(duì)卡方算液體培養(yǎng)法(LC1,LC2)的敏感度、特異度、準(zhǔn)確度等指標(biāo);采用Kruskal-Wallis秩和檢驗(yàn)分析各年齡組分布與干擾細(xì)菌分布的差異;采用t檢驗(yàn)比較標(biāo)本分離菌與同種標(biāo)準(zhǔn)菌株引起MP液體培養(yǎng)假陽性差別。結(jié)果三維配對(duì)卡方檢驗(yàn)得到CL1和CL2的靈敏度、特異度、誤診率、漏診率、約登指數(shù)分別為82.2%、90.2%、9.8%、17.8%、0.724和82.2%、96.4%、3.6%、17.8%、0.786;CL2的特異度較CL1有明顯的提高,差異有統(tǒng)計(jì)學(xué)意義(P0.05);CL1具有比CL2較高的誤診率;12歲以下年齡組與13~50歲、50歲以上年齡組的干擾細(xì)菌分布差異有統(tǒng)計(jì)學(xué)意義(P=0.01);各種分離菌使MP液體培養(yǎng)基產(chǎn)生假陽性的最低濃度較標(biāo)準(zhǔn)菌株低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 MP液體培養(yǎng)法(CL1)與改進(jìn)后的液體培養(yǎng)法(CL2)均具有較高的臨床診斷價(jià)值,但是需排除口咽部分離菌的干擾;CL2比CL1具有更高的特異性;咽部細(xì)菌較標(biāo)準(zhǔn)菌對(duì)MP液體培養(yǎng)法的影響更為明顯;咽部細(xì)菌對(duì)MP液體培養(yǎng)法影響與年齡階段分布相關(guān),較高年齡組(12歲以上)因具有較多的分離菌容易對(duì)MP液體培養(yǎng)基產(chǎn)生干擾。
[Abstract]:Objective to study the diagnostic value of (MP) liquid culture method for mycoplasma pneumoniae according to the standard of serum particle aggregation test (particle agglutination test,PA), and to explore the optimization method of liquid culture method. Methods from May 2014 to September 2014, 2991 patients were collected from our hospital. MP was detected by liquid culture method in throat swabs of patients, and the results (liquid culture,LC) were obtained. The positive solution of liquid culture method was isolated and cultured by plate. The cultured bacteria and their standard strains were quantitatively inoculated in MP liquid medium to judge the possibility of contamination. After screening false positive, the titer of Mycoplasma pneumoniae in serum of the same patient was detected by LC2.PA method. Compared with PA, three-dimensional matched chi-square method was used to calculate the sensitivity, specificity and accuracy of liquid culture (LC1,LC2), Kruskal-Wallis rank sum test was used to analyze the difference between the distribution of different age groups and interfering bacteria, and t test was used to compare the false positive difference of MP liquid culture between isolated bacteria and the same standard strain. Results the sensitivity, specificity, misdiagnosis rate and missed diagnosis rate of CL1 and CL2 were 82.2%, 90.2%, 8.8%, 17.8%, 96.4%, 3.6% and 17.8%, respectively, and the specificity of 0.786 鈮，

本文編號(hào)：2503143