鼻拭子和咽拭子在儿童流行性感冒病毒抗原检测中的比较研究

Comparison of nasopharyngeal swabs and oropharyngeal swabs in detection of influenza virus antigens in children

目的比较鼻拭子和咽拭子检测儿童流行性感冒(流感)样病例的流感病毒抗原检出情况。方法回顾分析2020年2月1日—2月29日在湖南省儿童医院就诊的320例有流感样症状患儿的临床资料;同时采集所有患儿鼻拭子和咽拭子,采用胶体金法检测甲型、乙型流感病毒抗原,对检测结果为阳性的患儿留取标本进行荧光聚合酶链反应(PCR)验证;比较两种拭子检测结果的差异。结果320例患儿的检测样本中,鼻拭子检出阳性率明显高于咽拭子〔20.3%(65/320)比14.1%(45/320),P<0.05〕;经荧光PCR验证的34例乙型流感病毒感染患儿中,鼻拭子抗原检测阳性率为100.0%(34/34),明显高于咽拭子抗原检测阳性率〔52.9%(18/34)〕,差异有统计学意义(P<0.01)。0~2岁组、3~5岁组、6~17岁组患儿的阳性检出率分别为14.4%(32/222)、35.7%(25/70)、28.5%(8/28),3组间比较差异有统计学意义(P<0.01)。结论采集鼻拭子可以提高流感病毒抗原阳性检出率,特别是对于乙型流感病毒,可以对患儿进行早发现、早隔离,并及时给予抗病毒治疗。

Objective To compare the detection situation of influenza virus antigen in children of influenzalike cases by nasopharyngeal swabs and oropharyngeal swabs.Methods The clinical data of 320 children with influenza-like symptoms who were admitted to Hunan Children's Hospital from February 1 to February 29,2020 were retrospectively analyzed.Nasopharyngeal and oropharyngeal swabs were collected at the same time.Influenza A and influenza B antigens were detected by influenza colloidal gold rapid antigen method.The samples with positive test results were verified by fluorescence polymerase chain reaction(PCR),and the results of the two kinds of swabs were compared.Results Among the test samples of 320 children,the positive rate of nasopharyngeal swabs was significantly higher than that of oropharyngeal swabs[20.3%(65/320)vs.14.1%(45/320),P<0.05].Among 34 children infected with influenza B virus verified by fluorescent PCR,the positive rate of nasopharyngeal swab antigen was 100.0%(34/34),which was significantly higher than that of oropharyngeal swab antigen[52.9%(18/34)],and the difference was statistically significant(P<0.01).The positive rates of 0-2 years old group,3-5 years old group and 6-17 years old group were 14.4%(32/222),35.7%(25/70)and 28.5%(8/28),respectively,and there was significant difference among the three groups(P<0.01).Conclusion Collecting nasopharyngeal swabs can improve the positive detectable rate of influenza virus antigen,especially for influenza B virus,and early detection,early isolation and timely antiviral treatment can be given to children.