荧光定量PCR法在孕晚期B族链球菌感染患者中的诊断分析

Diagnostic analysis of fluorescence quantitative PCR in B patients with streptococcus suis infection in third trimester

目的探讨荧光定量聚合酶链式反应(polymerase chainreaction,PCR)法在孕晚期B族链球菌感染诊断中的应用。方法选取2017年1月至2019年1月于本院检查的80例疑似B族链球菌感染孕晚期孕妇,分析其荧光PCR检测与细菌培养检测结果,以基因测序作为金标准,比较两种方法诊断效能。结果基因测序结果显示,80例孕妇中,52例为阳性,28例为阴性;荧光定量PCR法检出真阳性52例,假阴性0例,假阳性1例,真阴性27例;细菌培养检测检出真阳性44例,假阴性8例,假阳性8例,真阴性20例;以基因测序作为金标准,荧光定量PCR法对B族链球菌感染的诊断灵敏度、特异度、准确性、阴性预测值、阳性预测值分别为100.00%、96.43%、98.75%、100.00%、98.11%,高于细菌培养检测的84.62%、71.43%、80.00%、71.43%、84.62%,差异有统计学意义(χ^(2)=6.635、4.766、14.809、6.875、4.501,P=0.003、0.011、0.000、0.003、0.014);绘制ROC曲线得到荧光定量PCR法与细菌培养诊断孕晚期B族链球菌感染的AUC分别为:0.982、0.780,均>0.75,有一定预测价值,且以荧光定量PCR法效能更好。结论荧光定量PCR法在孕晚期B族链球菌感染诊断中诊断效能较高,可有效应用于早期诊断治疗。

Objective To investigate the application of fluorescence quantitative polymerase chain reaction(PCR)in the diagnosis of streptococcus B in the third trimester.Methods From January 2017 to January 2019,80 pregnant women with suspected Streptococcus B infection were selected,and the results of fluorescence PCR and bacterial culture were analyzed.The diagnostic efficacy of the two methods was compared with that of gene sequencing.Results Gene sequencing showed,of the 80 pregnant women,52 cases were positive,28 cases were negative;fluorescence quantitative PCR was used to detect 52 positive cases,false negative,one false positive,true negative 27 cases;in 44 cases,positive in bacterial culture,eight false negative cases,eight false positives,true negative 20 cases;Taking gene sequencing as the gold standard,the sensitivity,specificity,accuracy,negative predictive value,and positive predictive value of fluorescent quantitative PCR for group B streptococcus infection were 100.00%,96.43%,98.75%,100.00%,98.11%,respectively,higher than 84.62%,71.43%,80.00%,71.43%,84.62%of bacterial culture detection,the difference is statistically significant(χ^(2)=6.635,4.766,14.809,6.875,4.501,P=0.003,0.011,0.000,0.003,0.014);the AUC of fluorescence quantitative PCR and bacterial culture in the diagnosis of streptococcus B infection were 0.982,0.780,all>0.75,has some predictive value,and the fluorescence quantitative PCR method was more effective.Conclusion Fluorescence quantitative PCR method is highly effective in the diagnosis of streptococcus B infection in the third trimester,it can be effectively used in early diagnosis and treatment.