检测尿液中融合细胞早期快速诊断肾综合征出血热

Rapid diagnosis of hemorrhagic fever with renal syndrome by detection of fusion cells from urine

为了寻求肾综合征出血热（ＨＦＲＳ）早期、快速的诊断方法，对１９６例ＨＦＲＳ患者尿液融合细胞（ＦＣ）和血清特异性ＩｇＭ抗体进行了检测，阳性率分别为８５．２％（１６７／１９６）和９３．９％（１８４／１９６），两者差异无显著性（Ｐ＞０．９）。以ＥＬＩＳＡＩｇＭ抗体捕捉法为标准考核ＦＣ检测的诊断价值，结果ＦＣ的灵敏度是ＥＬＩＳＡ的８９．７％；特异度是８３．３％；阳性预告值为９８．８％；二者的诊断符合率为８９．３％。同一时期门诊的麻疹、水痘、风疹、流行性腮腺炎、乙型脑炎等患者尿ＦＣ阳性率（１３．９％、２０％、２．９％、０、０）与ＨＦＲＳ患者的相比差异有显著性（Ｐ＜０．００５）。本文结果提示：ＦＣ检测在一定程度上可以取代条件要求较高，操作比较复杂的ＥＬＩＳＡ。

In order to pursue a rapid diagnostic method for hemorrhagic fever with renal syn-drome(HFRS),we detected the fusion cells(FC)from the urine of 196 patients who were suspectedof contracting HFRS.At the same time,ELISA-IgM antibody-capture assay was used for the detec-tion of IgM against HFRS virus in their sera. The results showed that the positive rate of FC was85.2%(167/196)and the antibody IgM was 93.9%(184/196).By Chi-square test(χ2),there wasno significance between these two groups(P>0.9).Compared to ELISA,the sensitivity of FC de-tection was 89.7%,the specificity was 83.3%;with the positive predicative value of 98.8%and thediagnostic accordance rate of 89.2%.The positive rate of FC detected in HFRS patients was moresignificant than that in patients with measles,chickenpox,German measles,mumps,epidemic en-cephalitis B etc.(P<0.005)This indicated that the detection of FC in the urine from HFRS pa-tients might be used to replace the ELISA-IgM antibody-capture assay for diagnosis of HFRS at theearly stage of the disease, especially in endemic areas(e.g.countryside)far from cities.