上海市儿童下呼吸道感染常见病毒诊断方法比较

Comparison on diagnostic method of children lower respiratory tract infection by common virus in Shanghai

目的应用直接免疫荧光法(DFA)和多重逆转录聚合酶链反应(RT-PCR)对呼吸道感染患儿鼻咽分泌物的常见病毒进行检测,比较2种方法的符合率并评估其临床应用价值。方法选取急性呼吸道感染患儿鼻咽分泌物540例,分别用DFA和多重RT-PCR进行检测,分析其结果。结果 DFA检测阳性率为43.9%(237/540),多重RT-PCR检测阳性率为55.7%(301/540),多重RT-PCR阳性检出率显著高于DFA的阳性检出率(χ2=29.093,P<0.01)。DFA和多重RT-PCR同时阳性163例,DFA阳性而多重RT-PCR阴性74例,多重RT-PCR阳性而DFA阴性138例,DFA和多重RT-PCR同时阴性165例。DFA和多重RT-PCR同时为阳性的163例标本中,有15例标本两者检测结果不一致,符合率为91.0%。结论 DFA快速、简便、特异性及敏感性高,适用于临床检测。多重RT-PCR的敏感性高,检测病毒谱广,且可以做亚型鉴定,适用于呼吸道病毒流行病学的调查。

Objective To apply direct immuno-fluorescence assay（DFA）and multiplex reverse transcription-polymerase chain reaction（RT-PCR） to detect common virus in nasopharyngeal secretions,compare the coincidence rate of this 2 methods,and evaluate the clinical application value.Methods There were 540 samples of nasopharyngeal secretions collected from the children with respiratory tract infection.They were detected by DFA and multiplex RT-PCR,and the results were analyzed.Results DFA positive rate was 43.9%（237/540）,and multiplex RT-PCR positive rate was 55.7%（301/540）.The positive detection rate of multiplex RT-PCR was obviously higher than that of DFA（χ2=29.093,P0.01）.There were 163 cases positive for DFA and multiplex RT-PCR simultaneously,74 cases were DFA positive and multiplex RT-PCR negative,and 138 cases were multiplex RT-PCR positive and DFA negative.There were 165 cases negative for DFA and multiplex RT-PCR simultaneously.In the 163 DFA and multiplex RT-PCR both positive samples,the results of 15 cases were inconsistent,and the coincidence rate was 91.0%.Conclusions DFA is rapid and simple,and it has high specificity and sensitivity.It can be used to clinical application.Multiplex RT-PCR sensitivity was slightly high,and multiplex RT-PCR can detect viruses broadly.It can be used to subgroup identification and is suitable for respiratory tract virus epidemiology research.