摘要
目的评价肥达反应在儿童伤寒的诊断价值以及应注意的问题。方法对251例伤寒患儿中伤寒杆菌培养阳性的87例患儿(伤寒组)及922例非伤寒发热患儿(非伤寒组)的肥达反应结果进行分析。结果伤寒组肥达反应阳性率为97%(84/87),非伤寒组为4%(40/922),两组比较差异有统计学意义,P<0.001。肥达反应的敏感性为97%,特异性为81%,准确性为82%。伤寒患儿发病后1～4周的阳性率分别为79%、86%、94%、89%。66例伤寒患儿重复1次以上肥达反应,并非O、H抗体凝集效价都呈上升趋势。虽然非伤寒患儿肥达反应可呈假阳性反应,但O、H抗体凝集效价极少达到1:800。结论肥达反应仍是当今诊断儿童伤寒尤其是细菌培养阴性伤寒患儿的可靠、有意义的辅助性诊断指标,其价值应得到肯定。
Objective To evaluate the diagnostic value of Widal＇s reaction and some special attention related to children with typhoid fever. Methods The results of Widal test were analyzed retrospectively in 87 bacteriologically proven cases of typhoid fever （typhoid fever group） and 922 patients with non-typhoidal fever （non-typhoidal fever group）. Results There was statistical difference in positive rate of Widal test between typhoid fever group and non-typhoidal fever group （97% vs 4%,P〈0. 001）. The sensitivity of Widal test was 97%, the specificity was 81%, and the accuracy was 82%. The positive rate of Widal test in children with typhoid fever 1, 2, 3 and 4 week after onset was 79%, 86%, 94% and 89% respectively. Widal test was performed again in 66 typhoid fever cases, but not all of them showed elevated level of O and H agglutinin titres with the duration of illness. Although non-typhoidal febrile children displayed false positive reaction, little agglutinin valence approached 1 ： 800. Conclusion Widal＇s reaction is still considered to be a reliable and significant test for the diagnosis of typhoid fever in children, especially for patients with bacterial culture negative, and its diagnostic value should be confirmed.
出处
《检验医学与临床》
CAS
2007年第10期936-937,共2页
Laboratory Medicine and Clinic
关键词
肥达反应
伤寒
细菌培养
widal＇s reaction
typhoid fever
bacterial culture
