荧光免疫法、ELISA法与PCR在婴幼儿腹泻常见病毒检测中的价值

The value of fluorescence immunoassay, ELISA method and PCR in the detection of common virus in infants with diarrhea

目的探讨荧光免疫法、酶联免疫吸附试验(ELISA)法与聚合酶链式反应(PCR)检测婴幼儿腹泻常见病毒的结果与一致性。方法对急性腹泻婴幼儿61例分别用荧光免疫法、ELISA法、PCR技术对患儿粪便标本中肠道腺病毒、轮状病毒、星状病毒及诺如病毒抗原进行检测。结果荧光免疫法肠道腺病毒、轮状病毒、星状病毒及诺如病毒抗原阳性检出率分别为11.48%、11.48%、6.56%及13.11%;ELISA法上述病毒抗原阳性检出率分别为1.64%、27.87%、13.11%及29.51%,PCR上述病毒抗原阳性检出率分别为26.23%、1.64%、1.64%、1.64%。荧光免疫法与ELISA法对比,轮状病毒、诺如病毒抗原阳性检出率差异均有统计学意义(P<0.05),对于轮状病毒两种方法检测结果有较好一致性;荧光免疫法同PCR对比,肠道腺病毒、诺如病毒抗原阳性检出率差异有统计学意义(P<0.05),对于轮状病毒及肠道腺病毒,两种方法检测结果有较好一致性;ELISA法与PCR对比,4种病毒抗原阳性检出率差异均有统计学意义(P<0.05),对于4种病毒,两种方法检测结果有较好一致性。结论 ELISA法与PCR对婴幼儿腹泻常见病毒检测一致性较高,在临床诊断中,可采用ELISA法进行初筛,再通过PCR进行确认,以提高诊断效率及准确性。

Objective To study the detection results of common viruses in infants with diarrhea by fluorescence immunoassay, enzyme linked immunosorbent assay （ELISA） and polymerase chain reaction （PCR） and their consistency. Methods 61 sick infants with acute diarrhea admitted to the hospital from June 2014 to September 2015 were enrolled as research object. The enteric adenovirus, rotavirus, astrovirus and norovirus antigen in the fecal samples of the sick infants were detected with immunofluorescence method, ELISA method and PCR technique, respectively. Results The positive detection rate of the enteric adenovirus, rotavirus, astrovirus and norovirus antigen with fluorescence immunoassay was 11.48%, 11.48%, 6.56% and 13.11%, respectively; that with ELISA was 1.64%, 27.87%, 13.11% and 29.51%, respectively; and that with PCR was 26.23%, 1.64% 1.64% and 1.64%, respectively. For the comparison between immunofluorescence method and ELISA method, there was statistical difference in the positive detection rate of rotavirus and norovirus antigen （P〈0.05）, and the detection results of rotavirus had a good consistency between the two methods; For the comparison between immunofluorescence method and PCR, there was statistical difference in the positive detection rate of enteric adenovirus and norovirus antigen （P〈0.05）, and the detection results of rotavirus and enteric adenovirus had a good consistency between the two methods; For the comparison between the ELISA and PCR, there was statistical difference in the positive detection rate of the four viruses （P〈0.05）, and the detection results of four virus had a good consistency between the two methods. Conclusion The ELISA method and PCR have a high consistency in the detection of common virus of diarrhea in infants. In the clinical diagnosis, the ELISA method can be used for preliminary screening, and then PCR can be used for confirmation so as to improve the diagnostic efficiency and accuracy.