虎红平板凝集实验在布鲁菌病哨点医院监测中的作用与效果

The role and effect of RBPT in the monitoring of brucellosis sentinel hospitals

目的探讨RBPT试验在布鲁菌病哨点医院监测中的作用与效果。方法采用治疗性筛检方法,对2011年-2015年在国家级哨点监测医院就诊符合监测定义的病例,采用RBPT法和SAT法进行双向检验,采用SAT法作为诊断试验对RBPT法临床筛查效果进行评价。结果 650例监测病例中检出布鲁菌病27例,检出率为4.15%,RBPT筛检试验灵敏度为96.3%,特异度为98.9%,符合率为98.7%,阳性预测值为78.8%。SAT法抗体检测,呈高滴度(≥1∶100)共27例,均诊断布鲁菌病;呈低滴度(1∶25和1∶50)共30例,经随访观察,没有出现发病。结论 RBPT法具有灵敏、特异、廉价、操作简便等特点,在基层医院开展监测具有较实用的临床诊断价值。SAT法作为国家标准中的正式诊断试验,采用1∶100抗体滴度作为诊断界点,特异性好,科学性强,SAT低滴度者估计与既往隐性感染有关。

Objective To study the application and effect of RBPT in the brucellosis monitoring sentinel hospitals. Methods The patients satisfying the definition of monitoring cases were collected with therapeutic screening method from the national sentinel surveillance hospital during 2011- 2015,who were tested by RBRT and SAT,and then SAT was selected as a diagnostic test to assess the economic impact of RBPT method. Results 27 brucellosis patients were detected in the 650 cases,and the detection rate was 4. 15%. RBPT screening test sensitivity was 96. 3%,the specificity was 98. 9%,the coincidence rate was 98. 7%,and the positive predictive value was 78. 8%. Antibody testing by SAT method showed that 27 cases were diagnosed with brucella at high drop degree（ ≥1∶100）,and 30 cases were at low drop degrees（ 1∶25 and 1∶50）,after follow- up observation,there was no cases occurred. Conclusion RBPT method is sensitive,specific,inexpensive,easy to operate and so on. In the pathogenesis of key areas,to carry out the monitoring has a more practical clinical diagnostic value in the primary hospitals. As a formal diagnostic test in the national standard,SAT adopts 1∶100 drop as a diagnostic cut- off,which is specific and sciencitific,and patients with low drop degree was estimated with the recessive infections.