尿肺炎链球菌抗原检测在儿童肺炎链球菌肺炎诊断中的临床意义

吴雄基，陆俏群

(茂名市妇幼保健院儿科，广东茂名525000)

摘要：目的探讨尿肺炎链球菌抗原检测在儿童肺炎链球菌肺炎诊断中的临床价值。方法选取2013-02～2014-02在广东省茂名市妇幼保健院儿科住院的小于3岁的下呼吸道感染患儿298例，入院后留取痰培养，同时用尿标本检测肺炎链球菌抗原。结果298例患儿的痰液纯培养阳性率9.7%，尿肺炎链球菌抗原阳性率16.4%，痰液纯培养阳性组患儿的尿肺炎链球菌抗原阳性率(86.2%)明显高于阴性组(8.9%)(P<0.01)。尿肺炎链球菌抗原检测的敏感性为86.2%，特异性为91.1%，准确度为90.6%。结论尿肺炎链球菌抗原检测在儿童肺炎链球菌肺炎诊断中有较好的临床价值，与痰培养结合有助于提高该病的诊断准确率，值得临床推广应用。

关键词：肺炎；链球菌；尿肺炎链球菌抗原；儿童

中图分类号：R725.6

作者简介：吴雄基(1981—)，男，广东茂名人，茂名市妇幼保健院儿科主治医师。

[收稿日期2014-11-20；责任编辑徐文梅]

Clinical significance of detection for urine streptococcus pneumoniae

antigen in the diagnosis of children streptococcus

pneumoniae pneumonia

WUXiong-ji,LUQiao-qun

(Department of Neonatal,Maoming Municipal Maternity and Infant Health Institute,Maoming 525000,China)

Abstract：Objective To approach the clinical value of detection for urine streptococcus pneumoniae antigen in the diagnosis of children streptococcus pneumoniae pneumonia.Methods 298 cases with lower respiratory tract infection were selected,who were treated in pediatrics department from February,2013 to February,2014. All the patients were less than 3 years old.Sputum culture and urine streptococcus pneumoniae antigen were detected at the same time.Results In the 298 cases,the positive rate of sputum pure culture was 9.7% and urine streptococcus pneumoniae antigen were 16.4%.The positive rate (86.2%) of urine streptococcus pneumoniae antigen in sputum pure culture positive group was higher than that in negative group(8.9%)obviously(P<0.01).The sensitivity,specificity and accuracy of detection for urine streptococcus pneumoniae antigen were 86.2%,91.1% and 90.6%.Conclusion The detection for urine streptococcus pneumoniae antigen has superior value in the diagnosis of children streptococcus pneumoniae pneumonia. It can improve the diagnosis of the desesse accurary combined with sputum culture and worthy of clinial application.

Key words：Pneumonia; Streptococcus; Urine Streptococcus Pneumoniae Antigen; Children

社区获得性肺炎患儿占儿科住院病人的比例较大，部分病例由于病情危重抢救无效死亡，给家庭和社会造成很大的负担，而肺炎链球菌作为主要致病菌所占的比例超过50%[1]。目前对该致病菌的检测主要依靠痰培养、血培养等传统方法，而这些方法往往受限于耗时长、阳性率低、容易受抗生素使用影响等等。本研究旨在探讨尿肺炎链球菌抗原检测在儿童肺炎链球菌肺炎诊断中的临床价值，协助该病的早期诊断和准确诊断。

1资料与方法

1.1研究对象

选取2013-02～2014-02在广东省茂名市妇幼保健院儿科住院治疗的小于3岁的下呼吸道感染患儿298例，其中男性168例，女性130例。

1.2检测方法

所有患儿入院后均留取尿标本，用胶体金法检测肺炎链球菌抗原，同时留取痰液进行细菌培养。……