荧光RT-PCR检测与ELISA检测在戊肝临床诊断效果的比较分析

Comparative Analysis of RT-PCR and ELISA Detection in Clinical Diagnosis of Hepatitis E

目的探讨和比较荧光RT-PCR检测与ELISA检测在戊肝临床诊断的效果。方法从我院健康体检中心2013年1月至2016年1月的50500血清标本中随机选择100份作为研究标本。通过采用酶联免疫法对戊肝抗体的检测,然后再通过荧光RT-PCR检测法进行确诊,观察和比较两组检测方法的检查结果。结果阳性一致率为55%,阴性一致率为100%,总一致率为75%,Kappa值为0.59(0.4<Kappa≤0.75),表示两者一致性一般。ELISA阳性检出率为30%,PCR阳性检出率为50%,PCR阳性检出率明显高于ELISA,数据比较差异具有统计学意义,P=0.000<0.005。结论荧光RTPCR检测和ELISA检测在戊肝的诊断中都具有一定的检查准确度,同时荧光RT-PCR检测的阳性检出率明显高于ELISA检测。由于ELISA检测容易受到各方面因素的影响而发生漏诊的情况,因此建议对于ELISA检测出现可疑的标本,使用RT-PCR进行确诊,使更具可靠性。

Objective To explore and compare RT-PCR and ELISA detection on hepatitis E and clinical diagnostic value. Methods A total of 100 samples were randomly selected from 50500 serum samples in our hospital from January 2013 to January 2016. Samples were tested by ELISA, and then by RT-PCR. Results Were compared between the two groups. The positive agreement rate was 55 % and negative agreement rate was 100%. The total agreement rate was 80%. Kappa value was 0.87 （0.75 〈 kappa is less than or equal to 0.99）, and the correlation between two was slightly above average. The positive rate of ELISA was 30%, the positive rate of PCR was 50%, the positive rate of ELISA was significantly higher than that of PCR, the difference was statistically significant, P -- 0. 000 〈 0. 005. Conclusion RT- PCR and ELISA in the diagnosis of hepatitis E show equally specific. RT- PCR has higher positive rate than that of ELISA. It is recommended that ELISA can be used as first choice of screeningof suspicious specimens, RT-PCR can be added as aconfirmation of the diagnosis.