3种多病原核酸检测技术在儿童呼吸道感染病原学检测中的对比研究

Comparison of Three Multiple Nucleic Acid Determination Methods forDetermining Different Respiratory Pathogens in Children

目的比较3种多病原检测技术在呼吸道病原检测中的应用结果,为临床呼吸道感染的早期诊断提供依据。方法选取2019年9月至2019年11月首都儿科研究所附属儿童医院呼吸科收治的111例呼吸道感染病例样本,使用呼吸道病原体多重RNA双扩增法(方法1)、多重RT-PCR核酸扩增毛细管电泳法(方法2)和RNA恒温扩增微流控芯片法(方法3)3种多病原核酸检测技术检测呼吸道病原。通过四格表分析及Kappa检验一致性评价,比较3种方法对呼吸道病原的检出差异。结果方法1、2、3的病原检测出率分别为:18.92%、49.54%、38.74%。针对不同病原体指标分别进行方法学的两两分析,3种检测技术对腺病毒的检出一致性均较好,总符合率均大于95%;对副流感病毒,方法学1与方法学3的一致性较好;对呼吸道合胞病毒,方法学1与方法学2的一致性较好;对人鼻病毒/肠病毒,方法学2和方法学3检测一致性较差。结论3种多病原检测技术的结果一致性较好,但在个别指标及应用上存在一定差异,需结合临床实际情况参考使用。

Objective By comparing the results of different multiple nucleic acid detection technologies in the detection of respiratory pathogens,this study develops a reference model for nucleic acid detection in clinical laboratories and provides a knowledge basis for the early diagnosis of respiratory tract infection.Methods Three different nucleic acid detection techniques,Mutiple RNADouble Amplification Technology(method 1),Multiples polymerase chain reaction-capillary electrophoresis(method 2)and loop-mediated isothermal amplification assay(method 3),were used to detect 111 samples of respiratory tract infection in the Respiratory Department of Children’s Hospital of Capital Institute of Pediatrics from September,2019 to November,2019.The differences of pathogenic microorganisms detected by different methods were compared by four grid table analysis and Kappa test.Results The positive detection rates of methods 1,2 and 3 were 18.92%,49.54%and 38.74%,respectively.The two-way analysis of methodology was carried out for different_(p)athogen indexes.The detection results of Adenovirus showed a good consistence with the total coincidence rate with value of more than 95%;For parainfluenza virus,method 1 was consistent with method 3;For respiratory syncytial virus,method 1 was consistent with method 2;For human Rhinovirus/Enterovirus,the consistency of method 2 and method 3 was relatively poor.Conclusion Generally,the results of the three nucleic acid detection reagents are consistent,while there are still certain levels of differences in individual detection indexes and application,which need to be considered according to different clinical situations.