肺炎支原体核酸、IgM水平与炎症等指标的相关性分析及其在肺炎支原体感染诊断中的应用

Correlation Analysis of Mycoplasma pneumoniae Nucleic Acid and IgM Levels with Inflammation and Other Indicators and Its Application in the Diagnosis of Mycoplasma pneumoniae Infection

摘要: 目的：探讨肺炎支原体核酸(MP-DNA)、肺炎支原体IgM抗体(MP-IgM)与血细胞计数、炎症等指标的关系及在肺炎支原体感染诊断中的作用。方法：回顾性分析56例肺炎支原体感染患儿，比较各组患儿血细胞计数、炎症指标的差异。Pearson相关分析肺炎支原体IgM抗体水平与血细胞计数和炎症指标水平的相关性。结果：与MP-DNA阴性组相比，MP-DNA阳性组白细胞总数和中性粒细胞计数显著降低；炎症指标乳酸脱氢酶水平升高，血清铁水平降低。依据MP-IgM抗体水平分组，与MP-IgM抗体0~1组相比，MP-IgM抗体1~10组的白细胞总数，淋巴细胞和单核细胞计数显著升高；与MP-IgM抗体 ≥ 50组相比，MP-IgM抗体0~1和1~10组的血清铁显著降低。联合MP-DNA和MP-IgM水平分为三组(DNA+ IgM−, DNA+ IgM+, DNA− IgM+)，三组间白细胞总数，淋巴细胞和单核细胞计数以及乳酸脱氢酶和血清铁存在统计学差异。相关性分析发现：白细胞总数、淋巴细胞和单核细胞计数与MP-IgM水平呈正相关，C反应蛋白与MP-IgM水平呈负相关。MP-DNA对肺炎支原体感染诊断的灵敏度为75%，MP-IgM为55.4%，差异有统计学意义。结论：MP-DNA、MP-IgM与血细胞计数、炎症等指标存在关联，联合MP-DNA与MP-IgM检测可以反应肺炎支原体感染的时相，极大提高诊断肺炎支原体感染的病原学依据。

Abstract: Objective: To investigate the relationship between Mycoplasma pneumoniae nucleic acid (MP-DNA) and Mycoplasma pneumoniae IgM antibody (MP-IgM) with blood cell counts, inflammation and other indicators and their role in the diagnosis of Mycoplasma pneumoniae infection. Methods: Retrospective analysis of 56 children with Mycoplasma pneumoniae infections was performed to compare the differences in blood cell counts and inflammatory markers between groups. Pearson correlation analysis was used to analyze the correlation between Mycoplasma pneumoniae IgM levels and the levels of blood cell counts and inflammatory markers. Results: Compared with the MP-DNA negative group, the MP-DNA positive group had significantly lower total leukocyte counts and neutrophil counts; increased levels of the inflammatory marker lactate dehydrogenase and lower serum iron levels. Grouped according to MP-IgM levels, leukocyte counts, lymphocyte and monocyte counts were significantly higher in the MP-IgM 1~10 group compared with the MP-IgM 0~1 group; serum iron was significantly lower in the MP-IgM 0~1 and 1~10 groups compared with the MP-IgM ≥ 50 group. Combined MP-DNA and MP-IgM levels were categorized into three groups (DNA+ IgM−, DNA+ IgM+, DNA− IgM+), and significant statistical differences were found in leukocyte, lymphocyte, and monocyte counts as well as lactate dehydrogenase and serum iron among the three groups. Correlation analysis revealed that total leukocyte, lymphocyte and monocyte counts were positively correlated with MP-IgM levels, and C-reactive protein was negatively correlated with MP-IgM levels. The sensitivity of MP-DNA for the diagnosis of Mycoplasma pneumoniae infection was 75% and MP-IgM 55.4%, with statistically significant differences. Conclusion: MP-DNA and MP-IgM correlate with blood cell counts and inflammation, and combined MP-DNA and MP-IgM testing can reflect the temporal phase of Mycoplasma pneumoniae infection, greatly improving the pathogenetic basis for diagnosing Mycoplasma pneumoniae infection.