荧光聚合酶链式反应与酶联免疫吸附法筛查肠道病毒71型病原感染的比较研究

Comparative Research between Fluorogenic Quantitative Polymerase Chain Reaction and Enzyme-linked Immunosorbent Assay Applied in Diagnosing Enterovirus 71 Infection

目的比较肠道病毒71型(EV71)核酸与EV71-IgM抗体检测两种方法对临床诊断手足口患儿的意义。方法采用荧光定量聚合酶链式反应法对2011年4月20日-9月10日诊治的1 379例临床诊断为疑似手足口患儿进行肛拭子EV71核酸检测,同时用酶联免疫吸附法对血清标本进EV71-IgM抗体水平检测。结果 1 379例患儿EV71核酸的阳性为79例,阳性率为5.73%,EV71-IgM抗体阳性为82例,阳性率为5.95%,两者均阳性为32例。两检测方法一致率为95.2%,两者之间的阳性检出率差异无统计学意义(χ2=0.093,P=0.761)。结论应用EV71核酸及EV71-IgM抗体检测的两种联合监测,能更有效地提高手足口病患儿感染的诊断水平,对预防及对诊断手足口病有积极意义。

Objective To compare effect of enterovirus （EV） 71 nucleic acid detection and EV71-IgM antibody detection on clinically diagnosis of hand-foot-mouth disease in children. Methods Rectal swabs collected from 1 379 children who were clinically diagnosed from April 20, 2011 to September 10, 2011 as suspected patients with the hand- foot-mouth disease were detected by fluorogenic quantitative polymerase chain reaction to conduct EV71 nucleic acid detection. Meantime, enzyme-linked immunosorbent assay was used to conduct EV71-IgM antibody detection in serum samples collected from those children. Results In these 1 379 cases, 79 had positive EV71 nucleic acids with a positive rate of 5.73%; while 82 cases had positive EV71-IgM antibodies with a positive rate of 5.95%. There were 32 cases with positive EV71 nucleic acid and positive EV71-IgM antibody. The rate of consistent results of two detection methods was 95.2%. The positive rates of two methods had no negligible differences （x2=0.093, P=0.761）. Conclusion Combination of EV71 nucleic acid detection and EV71-IgM antibody detection, can improve the efficiency in diagnosing hand-foot-mouth disease in children and facilitate the protection and diagnosis of the disease.