目的 评估实时荧光核酸恒温扩增检测技术（SAT）在儿童肺炎支原体肺炎（MPP）早期诊断中的应用价值及影响因素分析。方法 选取2016年12月至2017年12月住院治疗的社区获得性肺炎患儿526例，采用颗粒凝集法检测MP血清学抗体（MP-Ab），并以此结果为参照，评价SAT用于诊断MPP的价值。结果 以血清MP-Ab检测结果确诊MPP患儿165例，MP-SAT诊断MPP的敏感度为90.9%（150/165）、特异度为97.9%（368/376），准确性高（约登指数为0.89），两者的一致性好（Kappa=0.90）。MP-SAT在短病程患儿中的诊断敏感度明显高于长病程患儿（P=0.031）；MP-SAT诊断敏感度明显高于单次血清MP-Ab（P=0.018），两者的一致性差（Kappa=0.039）；MP-SAT与双份血清MP-Ab一致性好（Kappa=0.91）。多因素logistic回归分析结果显示：病程（≥ 7 d）、院外应用大环内酯类药物治疗是影响MP-SAT检出结果的主要因素（P < 0.05）。结论 MP-SAT在MPP的早期诊断中应用价值高，可以有效弥补急性期单份血清MP-Ab检测的不足，辅助临床进行早期诊断；尽可能在病程早期（< 7 d）和大环内酯类药物应用前进行MP-SAT检测。

Objective To investigate the value of simultaneous amplification and testing (SAT) in the early diagnosis of Mycoplasma pneumoniae pneumonia (MPP) in children and related influencing factors. Methods A total of 526 children with community-acquired pneumonia who were hospitalized between December 2016 and December 2017 were enrolled. Particle agglutination was used to measure serum Mycoplasma pneumoniae (MP) antibody (MP-Ab). The value of SAT in the diagnosis of MPP was evaluated based on these results. Results Based on the results of serum MP-Ab measurement, 165 children were diagnosed with MPP. MP-SAT had a sensitivity of 90.9% (150/165), a specificity of 97.9% (368/376), and high accuracy (Youden index=0.89) in the diagnosis of MPP, suggesting that there was good consistency between these two methods (Kappa=0.90). The diagnostic sensitivity of MP-SAT in children with a short course of disease was significantly higher than that in children with a long course of disease (P=0.031). The diagnostic sensitivity of MP-SAT was significantly higher than that of single serum MP-Ab measurement (P=0.018), with poor consistency between these two methods (Kappa=0.039). MP-SAT had good consistency with double serum MP-Ab measurement (Kappa=0.91). The multivariate logistic regression analysis showed that course of disease (≥ 7 days) and out-of-hospital macrolide treatment were the main factors influencing the results of MP-SAT (P < 0.05). Conclusions MP-SAT has high value in the early diagnosis of MPP and can effectively cover the shortage of single serum MP-Ab test in the acute stage and thus provide help for early clinical diagnosis. MP-SAT test should be performed in the early stage of the disease (< 7 days) and before the application of macrolide treatment.