评价3种免疫学检测方法在儿童腺病毒感染诊断中的应用价值

An Evaluation of Three Immunological Assays in the Diagnosis of Adenovirus Infection in Children

目的2评价直接免疫荧光法、间接免疫荧光法与酶联免疫吸附法3种检测方法对儿童腺病毒感染诊断的应用价值。方法回顾性分析2019年1月至2021年1月间我院检验科接收的221例同时进行上述3种检测的病例,计算每种方法的灵敏度、特异性、阳性预测值、阴性预测值、Kappa值等,对3种检测方法进行配对χ^(2)检验,同时按年龄分组进行统计学分析。结果直接免疫荧光法灵敏度为58.49%、特异性为100%、阳性预测值为100%、阴性预测值为88.42%、Kappa值为0.682,间接免疫荧光法灵敏度为84.91%、特异性为100%、阳性预测值为100%、阴性预测值为95.45%、Kappa值为0.895,酶联免疫吸附法灵敏度为92.45%、特异性为80.36%、阳性预测值为59.76%、阴性预测值为97.12%、Kappa值为0.613,3种方法两两间比较差异均有统计学意义。按照年龄分组显示每组间接免疫荧光法的统计学指标具有优势。结论间接免疫荧光法特异性和阳性预测值较好,检测结果与临床诊断一致性较好,对于儿童腺病毒感染具有较好的应用价值。

Objective To evaluate the value of three different methods,including direct immunofluorescence assay(DFA),indirect immunofluorescence assay(IFA)and enzyme linked immunosorbent assay(ELISA),on detection of children’s infection with adenovirus.Methods A retrospective analysis contained 221 cases in our hospital from January,2019 to January,2021 was conducted,and all cases used three methods to detective adenovirus simultaneously.We calculated sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and Kappa value for three methods,and used McNemar test to compare the performance of methods.According to age groups,we also carried out statistical analysis.Results The sensitivity,specificity,PPV,NPV and Kappa for DFA were 58.49%,100%,100%,88.42%,and 0.682,respectively.The sensitivity,specificity,PPV,NPV and Kappa for IFA were 84.91%,100%,100%,95.45%,and 0.895,respectively.The sensitivity,specificity,PPV,NPV and Kappa for ELISA were 92.45%,80.36%,59.76%,97.12%,and 0.613,respectively.The differences of three methods were statistically significant.According to age groups,the statistical indexes of IFA in each group had advantages.Conclusion IFA has a good specificity and PPV,the results are consistent with clinical diagnosis,and it has a good diagnostic value for adenovirus infection in children.