斑点免疫酶渗滤法快速检测甲型流感病毒的临床应用

Clinical application of dot immunoenzyme filtration assay for rapid detection of influenza A virus

目的明确快速筛查甲型流感病毒的方法。方法收集2009年11月至2010年3月就诊于广州医学院第一附属医院发热门诊及中医科门诊40例流感样患者的鼻咽分泌物进行病毒检测，男18例，女22例，年龄5-62岁，平均年龄（31．3±13．2）岁。以2009年9月卫生部颁布的qRT-PCR方法检出甲型流感病毒作为诊断标准，比较2种快速病原检测法——斑点免疫酶渗滤法（DIEFA）和胶体金免疫层析法（GICA）对甲型流感病毒的检出率，以确定敏感性好、特异性高的方法为甲型流感病毒快速筛查法。结果40例标本中，qRT-PCR检出甲型流感病毒21例，阳性率为52．5％；DIEFA检出甲型流感病毒22例，检出率为55．0％；GICA检出甲型流感病毒12例，检出率为30．0％。与qRT-PCR比较，DIEFA的灵敏度、特异性和一致性分别是85．7％、78．9％和82．5％，而GICA的灵敏度、特异性和一致性分别是42．8％、84．2％和62．5％。DIEFA对甲型流感病毒检出的灵敏度明显优于GICA（P〈0．05）。结论DIEFA方法检测甲型流感病毒具有灵敏度高及特异性好的优势，适用于流感流行季节对甲型流感病毒的快速诊断和筛查。

Objective To explore an approach for rapid influenza A virus detection. Methods Nasopharyngeal swab specimens were collected for influenza A virus detection from 40 patients with suspected influenza who visited the First Affiliated Hospital of Guangzhou Medical College from November 2009 to March 2010. According to Ministry of Health of China in September 2009, the diagnostic criteria for the infection of influenza A is a positive test for influenza A virus via qRT-PCR. Based on the positive result with qRT-PCR, we compared clot immunoenzyme filtration assay （DIEFA） with gold immunochromatography （GICA）, the two rapid antigen tests, and the one with higher sensitivity and specificity would be the choice of rapid influenza A virus detection. Results 21 cases werefounded influenza A virus positive by the way of qRT-PCR, the positive rate was 52.5%. 22 cases were found influenza A virus positive via DIEFA, the positive rate was 55.0%, while 12 cases were found influenza A virus positive via colloid GICA with a positive rate of 30.0%. Compared with qRT-PCR detection, the sensitivity, specificity and consistency of DIEFA were 85.7%, 78.9% and 82.5% respectively, while the sensitivity, specificity and consistency of GICA were 42.8%, 84.2% and 62.5% respectively. The data showed that DIEFA had apparent superiority of sensitivity over GICA in rapid influenza A virus detection. Conclusions DIEFA can be an optimal approach for rapid detection of influenza A virus with the advantage of higher sensitivity and specificity, adapting for screening influenza A virus rapidly in influenza A virus epidemic conditions.