间接免疫荧光法检测麻疹抗原在麻疹早期诊断中的临床应用

Clinical application of indirect immunofluorescence assay to detect measles virus antigen in early diagnosis

目的 :探讨间接免疫荧光法 (IndirectimmunofluorescenceAssay ,IFA)检测麻疹病毒抗原对儿童麻疹病毒 (measlesvirus,MV)感染的早期诊断价值。方法 :观察 86例临床诊断麻疹的患儿 ,在发病的不同阶段IFA检测痰液MV抗原和酶联免疫吸附试验 (enzymelinkedimmunosorbentassay ,ELISA)检测血清中MV特异性IgM抗体 ,采集 30份上呼吸道感染患者痰液进行IFA麻疹病毒抗原检测 ,比较分析检测结果。结果 :86例中发病 7d内IFA测抗原ELISA测抗体两种方法的阳性率为分别为 97.1%和 16 .2 % ;7d后为 33.3%和 88.9% ,P均 <0 .0 1。IFA测抗原阳性率与检测时间的相关系数为 - 0 .91,P =0 .0 2 ;ELISA测抗体阳性率与检测时间的相关系数为 0 .97,P =0 .0 4。 30份对照组的标本MV抗原检测均为阴性 ,IFA测抗原的特异性与敏感性分别是 10 0 %和 97.1%。结论 :IFA测抗原在疾病早期检出阳性率高 ,阳性检出率与检测时间成负相关 ,IFA测抗原痰液麻疹病毒抗原是一种早期快速、特异敏感的实验室检测方法。

Objective: To evaluate the diagnostic value of detecting measles virus(MV) antigen from spu tum in children's measles virus infected cases by Indirect Immunofluorescence as say(IFA). Methods:86 patients diagnosed clinically were enrolled in this study. In all the cases MV antigen in the sputum were examined with IFA and serum Ig M antibody with ELISA(enzyme linked immunosorbent assay) in different periods,and MV antigen in the sputum was also examined with IFA in 30 patients of acu te respira tory infection, to compare and analyze the results. Results:Among 86 cases within seven days , the positive rates o f IFA detection antigen and ELISA detection antibody were 97.1% and 16.2%,res pec tively; while IFA 33.3%, ELISA 88.9%, P<0.01 seven days later. The correlation coefficient between the positive rate of IFA detectio n antigen a nd detection time was -0.91, P=0.02; ELISA 0.97, P =0.04. MV antigen detection was negative in thirty control specimens . The sp ecificity and sensitivity of IFA to detect MV antigen were 100% and 96.2%,respe ctively. Conclusion:The positive rate is high in detecting the antigen of MV at early stage of measles. It is negatively correlated between positive d etection rate and checking time. IFA is early quickly specific and sensitive l ab detection method in diagnosis of MV infection .