目的探讨咽拭子肺炎支原体(MP)-DNA检测诊断儿童肺炎支原体肺炎(MPP)的价值。方法选取2014年11月1日-2015年10月31日于北京市房山区良乡医院儿科住院的疑为MPP,并经阿奇霉素或红霉素治疗有效的患儿229例(研究组)及同期住院的非呼吸道疾病患儿36例(对照组)。所有入选患儿均于入院当天采集咽拭子标本,应用荧光探针PCR检测MP-DNA。研究组患儿于入院24 h内留取血清标本检测MP-IgM,阴性者5~10 d后再次检测,仍为阴性者出院1周后复测。结果研究组患儿中,发现MP-DNA阳性98例(42.79%),MP-IgM阳性78例(34.06%),其中第1次血清检测阳性29例(12.66%),第2次血清检测阳性49例(21.40%),两种方法检测阳性率比较,差异有统计学意义(χ~2=5.309,P=0.021),两者一致性较差(Kappa=0.378,P<0.05)。151例MP-IgM阴性患儿出院后1周MP-IgM阳转23例,故MP-IgM总阳性例数为101例(44.10%),与MP-DNA检测阳性率比较,差异无统计学意义(χ~2=0.082,P=0.775),两者一致性中等(Kappa=0.565,P<0.05)。对照组患儿鼻咽分泌物MP-DNA仅3例(8.33%)阳性,与研究组比较,差异有统计学意义(P<0.05)。结论应用荧光探针PCR检测MP-DNA可早期诊断MPP,但应注意假阴性及假阳性的存在,需结合其他诊断方法得出科学的结论。 Objective To investigate the value of detecting throat swab Mycoplasma pneumoniae (MP) -DNA in the diagnosis of Mycoplasma pneumoniae pneumonia (MPP) in children. Methods Totally 229 children (study group) with MPP suspected of being hospitalized in pediatric department of Liangxiang Hospital, Fangshan District, Beijing from November 1, 2014 to October 31, 2015 and who were treated with azithromycin or erythromycin and the same period Inpatients with non-respiratory disease in 36 cases (control group). Throat swab samples were collected on the day of admission and MP-DNA was detected by fluorescent probe PCR. Children in the study group were taken serum samples for detection of MP-IgM within 24 hours after admission, and those who were negative again tested after 5 to 10 days. Patients who were still negative were retested one week after discharge. Results In the study group, MP-DNA positive was found in 98 (42.79%) and MP-IgM positive in 78 (34.06%) patients, of which 29 were positive for the first serum test (12.66% There was a significant difference between the two methods (χ ~ 2 = 5.309, P = 0.021). The consistency between the two methods was poor (Kappa = 0.378, P <0.05). Among the 151 MP-IgM-negative children, 23 were MP-IgM positive one week after discharge from the hospital, so the total number of MP-IgM positive cases was 101 (44.10%). There was no significant difference in the positive rate of MP- (χ ~ 2 = 0.082, P = 0.775), the agreement between the two was moderate (Kappa = 0.565, P <0.05). Only 3 cases (8.33%) of nasopharyngeal secretions MP-DNA in control group were positive, compared with the study group, the difference was statistically significant (P <0.05). Conclusion The detection of MP-DNA by fluorescent probe PCR can be used to diagnose MPP early. However, we should pay attention to the existence of false-negative and false-positive, and we must draw scientific conclusions with other diagnostic methods.