新型冠状病毒肺炎的实验室检测现状

The Current Status of Laboratory Tests for Novel Coronavirus Pneumonia

新型冠状病毒短期内肆虐全国,特别是在湖北地区引起严重的疫情感染。及时有效地进行新型冠状病毒感染的实验室检测及监测,对于疾病诊治和疫情防控,具有重大意义。本文主要从常规项目检测及病原学检测两个方面,对新型冠状病毒肺炎(novel coronavirus pneumonia,NCP)的实验室检测现状进行阐述。新型冠状病毒肺炎患者可出现血尿、凝血功能、肝功能的异常。重症者可引起心肌及肾脏损伤标志物的异常。同时,利用血气分析可判断患者是否发生急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)。另外,细胞因子等感染免疫标志物的检测可有助于评估患者感染后的免疫状态。新型冠状病毒肺炎的诊断依赖于感染病原体的检出,包括基于分子生物学的病毒核酸的检测以及病毒特异性IgM抗体和IgG抗体的检测。RT-PCR为最常用的病毒核酸检测方法,基因测序可提供病毒宏基因组信息。病毒特异性IgM抗体和IgG抗体的检测,可与核酸检测互补,两者联合分析可降低检测的假阴性率。患者合并其他呼吸道病毒及细菌真菌的感染问题不容忽视,同时进行其他呼吸道病毒及细菌真菌的检测可有效避免交叉感染。

In 2019,the novel coronavirus wreaked havoc across the country in a short period of time,especially in Hubei province.It is very significant for disease diagnosis,treatment,epidemic prevention and control to have a timely and effective laboratory detection and monitoring pipeline of novel coronavirus infection.In this paper,we described the current status of laboratory detection of novel coronavirus pneumonia from two aspects:routine item detection and pathogen detection.New coronavirus pneumonia patients can show abnormalities in tests of routine blood and urine,blood coagulation function,as well as liver function,while severe cases can have the abnormalities of cardiac and kidney markers.At the same time,arterial blood gas analysis can determine whether acute respiratory distress syndrome occur.In addition,the detection of cytokines and other immune markers of infection can help to evaluate the immune status of patients after the infection.The diagnosis of novel coronavirus pneumonia depends on detections of infectious agents,including viral nucleic acids based on molecular biology and virus-specific IgM and IgG antibodies.RT-PCR is the most commonly used method for the detection of viral nucleic acid,and gene sequencing can provide viral metagenomic information.The detection of virus-specific IgM and IgG antibodies can complement with nucleic acid testing.The combined analysis of these two methods can reduce the false negative rate of testing.In the meantime,the infection of patients with other respiratory viruses,bacteria and fungi should not be ignored.The detection of those respiratory viruses,bacteria and fungi can effectively avoid cross-infection.