三种婴幼儿A组轮状病毒检测方法的方法学评价

Evaluation of different methods for the detection of group A rotavirus in infants

目的比较婴幼儿A组轮状病毒三种不同检测方法的优劣性。方法选择318例婴幼儿粪便或肛拭子标本分别行酶联免疫吸附(ELISA)、聚丙烯酰胺凝胶电泳(PAGE)、胶体金法(GICA)、荧光定量逆转录聚合酶链式反应(RT-PCR)检测A组轮状病毒,并以荧光定量RT-PCR为标准,对ELISA、PAGE、GICA进行方法学评价。结果四种检测方法阳性率:ELISA 55.0%、PAGE 43.1%,GICA 53.2%,RT-PCR 58.5%;以RT-PCR为对照,灵敏度(91.4%)、约登指数(0.876)、符合率(93.4%)、阴性预测值(95.5%)以ELISA最高,特异度(99.2%)、阳性预测值(99.3%)以PAGE最高。结论 ELISA、GICA检测A组轮状病毒操作简单,方法学评价指标良好,适合在基层医院推广应用。

Objective To compare different methods for the detection of group A rotavirus in infants. Methods Group A rotavirus were examined in 318 infant stool or rectal swab specimens by enzyme - linked immunosorbent assay （ELISA） , polyaerylamide gel electrophoresis （ PAGE）, colloidal gold immunoehromatographic assay （GICA） , and quantitative RT - PCR. Quantitative RT - PCR was selected as the standard of comparison for methodology evaluation. Results Positive rates of group A rotavirus were ： ELISA 55% , PAGE 43.1% , GICA 53.2% and RT - PCR 58.5%. ELISA showed highest sensitivity （ 91.4% ） , Youden＇s index （ 0. 876 ） , accuracy （ 93.4% ）, and negative predictive value （ 95.5% ）. PAGE showed highest specificity （ 99.2% ） and positive predictive value （ 99.3 % ）. Conclusion ELISA and GICA has the ad- vantages of simple operation and gives good evaluation index. They are suitable for application in basic level hospital.