布鲁氏菌病6种血清学检测方法的临床应用比较

Comparation of six kinds of brucllosis serological tests in clinical application

目的了解荧光偏振试验(FPA)、虎红平板凝集试验(RBT)、试管凝集试验(SAT)、补体结合试验(CFT)、间接ELISA试验(i ELISA)、竞争ELISA试验(c ELISA)等6种血清学方法检测布鲁氏菌病的临床适用性。方法应用FPA、RBT、SAT、CFT、i ELISA、c ELISA对采集的321份牛血清样本进行布鲁氏菌病抗体检测。以c ELISA检测结果作为参考标准分别统计FPA、RBT、SAT、CFT、i ELISA的敏感性、特异性、阳性预测值、阴性预测值。结果 321份样本中有26份为阳性,295份为阴性。FPA、RBT、SAT、CFT、i ELISA的敏感性分别为96.15%(25/26)、65.38%(17/26)、65.38%(17/26)、38.46%(10/26)、80.77%(21/26);特异性分别为100.00%(295/295)、100.00%(295/295)、99.66%(294/295)、100.00%(295/295)、100.00%(295/295)。FPA、RBT、SAT、i ELISA、c ELISA 5种方法间经两两比较,其检测阳性率无显著差异(P>0.05),而CFT检测灵敏度明显低于i ELISA、FPA、c ELISA(P<0.05)。结论 FPA具有较高的敏感性和特异性,FPA可用于布鲁氏菌病抗体临床检测。

Objective To investigate the clinical utilization and the validation of the fluorescence polarization assay （FPA）, rose bengal test（RBT）, serum agglutination test（SAT）, complement fixation test（CFT）, indirect enzyme- linked immunosorbent assay（iELISA）, competitive enzyme-linked immunosorbent assay （cELISA） in the diagnosis of brucellosis. Methods Six kinds of serological tests including FPA,RBT,SAT,CI-,iELISA,cELISA were employed to detect 321 sera samples from bovine. The sensitivity, specificity, positive predictive value and negative predictive value of FPA,RBT,SAT,CFT,iELISA were calculated statistically with the results of cELISA which selected as reference method. Results The sensitivities of the FPA,RBT,SAT,CFT,iELISA were 96.15%（25/26）,65.38% （17/ 26） ,65.38% （17/26） ,38.46% （10/26） ,80.77% （21/26）, respectively; while the specifities were 100.00% （295/295）, 100.00% （295/295） ,99.66% （294/295）, 100.00% （295/295）, 100.00% （295/295）. There was no significant difference in the detection result of FPA,RBT,SAT,iELISA,cELISA with each other （P〉 0.05）, while the sensitivity of CFT was lower than iELISA,FPA,cELISA obviously （P〈 0.05）. Conclusion FPA is a highly specific and sensitive methods in clinical detection for brucellosis.