甲型H1N1流感病毒临床实验室诊断策略

Clinical Laboratory Diagnostic Strategies of Influenza A/H1N1 Virus

目的 探讨用于甲型H1N1流感患者临床实验室诊断的策略.方法 采用Dot-ELISA法检测流感患者中的甲型流感病毒的抗原,初步明确为甲型流感或排除非甲型流感;采用real-time RT-PCR法检测甲型流感病毒抗原阳性患者中的甲型H1N1流感病毒特异性核酸,进一步确定甲型H1N1流感病毒.结果 对44 448例在西安地区就诊的发热伴有流感样症状者的鼻咽腔取分泌物进行甲型流感病毒抗原筛查,其阳性筛检率为28.25%;对甲型流感病毒抗原筛查阳性的17 714例患者进行甲型H1N1流感病毒核酸检测,其阳性检出率为41.92%.结论 首先用甲型流感病毒抗原筛查,排除非甲型流感病毒;进而在甲型流感病毒的范围内进行甲型H1N1流感病毒的检测,即加快了甲型流感病毒的排查效率,又减轻了甲型H1N1流感病毒核酸检测的压力;进而又减轻了大部分非甲型H1N1流感患者核酸检测的经济负担.该文认为该检测策略为甲型H1N1流感病毒的临床实验室诊断提供了参考,可为甲型H1N1流感病毒感染的控制、诊断,以及合理用药和针对性治疗提供依据.

Objective To study a clinical laboratory diagnostic strategy for influenza A/H1N1 patients. Methods To detect the influenza A virus antigen by Dot-ELISA method in influenza patients, initially diagnosed as influenza A or non-influenza ;for the influenza A virus antigen-positive patients ,further testing influenza A/H1N1 virus-specific nucleic acid using real-time RT-PCR method. Results For 44,448 cases of influenza patients in xi＇an to screened influenza A virus antigen, the positive rate as 28.25% ;further detected influenza A/H1N1 virus nucleic acid for 17 714 cases of antigen-positive patients,the positive rate of 41.92%. Conclusion First screening the influenza A virus antigen,to exclude non-influenza A virus;and then within the framework of influenza A virus to detect influenza A/H1N1 virus,that increased the detection efficiency of influenza A viruses,but also reduced the pressure on influenza A/H1N1 virus nucleic acid testing and the economic burden of patients. This detection strategy provided reference for laboratory diagnosis of influenza A/H1N1,and more effective control,diagnose influenza A/H1N1 virus infection.