麻疹病毒核酸和IgM抗体检测的应用比较分析

Comparison of real-time PCR with enzyme linked immunosorbent assay in detection of measles virus

目的通过麻疹疑似病例检测,比较分析核酸检测和IgM抗体检测在麻疹诊断中的应用。方法应用RT-PCR法检测西安市2014—2018年504例疑似麻疹病例咽拭子样本的麻疹病毒RNA,ELISA法则检测同时采集的血清标本中麻疹病毒IgM抗体。结果504例的疑似病例中,实验室确诊总阳性数133例,其中RT-PCR检测麻疹病毒RNA阳性90例,阳性检出率为17.86%(90/504);ELISA法检测麻疹病毒IgM抗体阳性124例,阳性率为24.60%(124/504);总阳性检出率为26.39%(133/504)。2种方法的检测结果差异有统计学意义(χ2=6.858,P=0.009)。在出疹后3 d内,ELISA法检测的阳性检出率显著高于RT-PCR法,差异有统计学意义(χ2=4.596,P=0.032)。结论麻疹实验室检测中应将病毒核酸检测和IgM抗体检测结合使用,以确保实验室检出率。

Objective To compare nucleic acid test and enzyme linked immunosorbent assay(ELISA)in the detection of measles,so as to provide scientific basis for the selection of detection method,diagnosing and controlling the disease as soon as possible.Method IgM antibody to measles virus was detected by ELISA in 504 cases of suspected measles in Xi’an from 2014 to 2018.Measles viral RNA from throat swab specimens was detected by real-time RT-PCR.Result Among the 504 suspected cases,the laboratory tests confirmed 133 positive cases,and the total positive rate was 26.39%;RT-PCR detected measles virus RNA in 90 cases,and the positive rate was 17.86%;ELISA detected 124 cases of measles virus IgM antibody,and the positive rate was 24.60%.The difference between the two method was statistically significant(χ2=6.858,P=0.009).Within 3 days after rash,the positive rate of ELISA was significantly higher than that of RT-PCR,and the difference was statistically significant(χ2=4.596,P<0.05).Conclusion ELISA and RT-PCR should be used together for rapid diagnosis of measles at early stages.