目的比较肺炎链球菌经典血清分型法与分子分型法，为建立快速、准确的血清分型方法提供依据。方法选取2013年10月～2015年2月肇庆市第一人民医院住院患者分离的150株肺炎链球菌为研究对象，分别采用经典荚膜肿胀法和多重PCR法进行血清分型。比较两种方法的分型率及血清分型结果，用两独立样本的非参数检验对分型率高的几种血清型进行统计分析对比，并计算结果的总符合率、灵敏度及特异度。结果肺炎链球菌经典荚膜肿胀法分型率为53.3％，血清群以19群（32.7％），6群（7.3％）和23群（4％）为主，使用单因子血清分得血清型19F（23.3％），19A（2.7％），6 C（2％）和23 F（2.7％）。多重PCR法分型率为76.0％，血清群以19群（41.3％），6群（10.7％）和23群（10.7％）为主，具体的血清型以19F（32.7％），19A（8.0％），6（10.7％）和23F（9.3％）为主，采用两独立样本的非参数检验进行比较，以血清型结果为19F，19A和23F作对比，统计结果P＞0.05，显示两种分型方法结果分布类别上相同，无显著性差异；两种方法结果总符合率为74.6％；以多重PCR法验证经典荚膜肿胀法的敏感度，敏感度为70.2％，特异度为100％，显示经典荚膜肿胀法敏感度不及分子分型法。结论与传统的血清学分型技术相比，分子分型技术具有快速、准确、灵敏及分辨力高等优点，成为可依赖的分型手段。%Objective To compare classical and molecular typing methods for Streptococcus pneumoniae,in order to provide fasty and accurate method for classification.Methods Selected the 150 strains of Streptococcus pneumoniae which isolated from the First People’s Hospital of Zhaoqing from October 2013 to February 2015 for the research objects,using the classi-cal quellung classification method and molecular typing of multiple PCR method for classification.Compared the result and the rate of the classification,used the non parametric test of two independent samples for statistical analysis several higer rate of serotypes,and calculated the total coincidence rate,sensitivity and specificity.Results The typing rate of Streptococ-cus pneumonia capsular was 53.3%,and the main serum group were 19(32.7%),6(7.3%)and 23(4%)respectively.The serotype of 19F(23.3%),19A(2.7%),6C(2%)and 23F(2.7%)respectively by single factor serum.The typing rate of the multiple PCR method was 76.0%,and the main serum group were 19(41.3%),6(10.7%)and 23(10.7%).The serotype were mainly 19F(32.7%),19A(8.0%),6(10.7%)and 23F(9.3%).Used the 2 Independent Sample Test for statistical a-nalysis,compared with the serotypes 19F,19A and 23F(P>0.05).There was no statistically significant difference in the distribution of the types of the two methods.The total coincidence rate was 74.6%.To verify the classic quellung method by multiple PCR method,sensitivity was 70.2%,and specificity was 100%.That showed the capsular swelling method was less sensitivity than the molecular typing method.Conclusion Compared with the traditional serological typing techniques,mo-lecular typing technique have the advantages of fast,accurate,sensitive and high resolution,and become the classification method which can be rely on.
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