门诊季节性流感快速检测筛查条件探讨

Discussion of Seasonal Influenza Screening Conditions in Outpatient Department by Rapid Detection

目的以单独或联合筛查方法对流行性感冒快速检测结果进行分析,为临床流感快速检测筛查条件的确定提供科学依据。方法对2008年5月-2009年7月北京军区总医院发热门诊共769例上呼吸道感染患者鼻咽分泌物样本,进行甲、乙型流感病毒的免疫胶体金层析法快速检测,对检测结果指标及其组合进行分类分析。结果 769例样本共检出阳性12例,检出率1.6%,检出阳性者年龄15～50(26.7±9.7)岁,体温37.5～39.2(38.4±0.6)℃,多见于12、1月份;单因素筛查的最优指标为流感样病例,灵敏度75%,特异度71%;多因素筛查的最优指标为流感样病例+发病2d内就诊,灵敏度75%,特异度77%。结论以流感样病例和发病2d内就诊为联合筛查指标对上呼吸道感染患者进行流感病毒的快速检测,可以提高流感诊断的灵敏度和特异度,临床上可以根据不同的目的选用不同的联合筛查方法。

OBJECTIVE To analyze results of rapid detection of influenza with single or combined screening methods,to provide scientific basis for the establishment of screening conditions in clinic.METHODS From May 2008 to Jul 2009,this study detected the antigens of flu A and B by colloidal gold immunochromatographic assay（GICA）in the secretion of nasal pharynx from 769 patients in the outpatient department of General Hospital of Beijing Command.RESULTS From them,there were 12 positive（detection rate：1.6%）,whose age was 15-50（26.7±9.7）,and the body temperature was 37.5-39.2（38.4±0.6）℃,which were mostly found in the Dec of the last year and the Jan of 2009.The optimal indication of a anifactorial screening methods was influenza-like cases（sensitivity：71%;specificity：75%）,while of combined screening methods was influenza-like Sick in two days ＋ cases（sensitivity：75%;specificity：77%）.CONCLUSIONS The combined screening methods of influenza-like sick in two days can increase the sensitivity and specificity of rapid detection of influenza for the patients with upper respiratory tract infection（URI）.Different screening methods can be shosen for different purposes.