摘要
目的分析了解深圳地区秋冬季婴幼儿腹泻标本中轮状病毒、诺如病毒、星状病毒，肠道腺病毒4种主要急性胃肠炎病毒的感染情况。方法收集深圳地区多家医院2007年10月—2008年2月腹泻患儿粪便标本192份，分别采用ELISA检测4种病毒抗原及采用PCR技术检测病毒核酸，阳性标本的PCR产物经纯化、测序加以验证，并比较2种方法应用效果。结果ELISA和PCR从192份标本共检出病毒156例，检出率为81．3％（156／192），4种病毒的阳性率分别为轮状病毒62．0％（119／192），诺如病毒17．7％（34／192），肠道腺病毒16．7％（32／192），星状病毒3．1％（6／192），其中混合感染率为16．7％（32／192）；ELISA技术和PCR技术对4种病毒的检出率分别为轮状病毒52．6％和50．5％（X^2=0．4，P〉0．05），诺如病毒8．3％和12．0％（X^2=1．24，P均〉0．05），肠道腺病毒7．3％和11．5％（X^2=1．75，P〉0．05），星状病毒1．6％和2．1％（X^2=0，P〉0．05），2种方法检出率的差异无统计学意义（，值分别为0．4、1．24、1．75及0，P均〉0．05）；2种方法对轮状病毒的检测具有较好的一致性（Kappa值为0．58），对诺如病毒、肠道腺病毒和星状病毒的检测一致性较差（Kappa值分别为0．18、0．15和0．27）。结论轮状病毒仍是深圳地区婴幼儿秋冬季腹泻的最主要病原，其次为诺如病毒和肠道腺病毒，病毒混合感染比例较大。ELISA与PCR技术在对诺如病毒、肠道腺病毒和星状病毒的检测上具有互补性，联合应用可提高诊断率。
Objective To investigate the prevalence of rotavirus, norovirus, astrovirus and enteric adenovirus among the acute infantile diarrhea in autumn and winter in Sbenzben and compare enzyme-linked immunosorbent assay （ELISA）with polymerase chain reactions （PCR） in detecting the four acute gastrointestinal viruses. Methods Fecal specimens were collected from 192 outpatients under 3 years old with acute diarrhea from October 2007 to February 2008 in Sbenzben. ELISA was used to detect the viral antigens and PCR was used to detect nucleic acids of four viruses. The PCR products were purified and sequenced. Results Among 192 fecal specimens, 81.3% were identified for at least one virus by either of ELISA or PCR, which included 119 for rotavirus （ 62. 0% ） , 34 for norovirus （ 17.7% ）, 32 for enteric adenovirus （16. 7% ）, 6 for astrovirus （3.1%）,and 32 for mixed infections（ 16.7% ）. The positive rate of ELISA and PCR were 52. 6% and 50. 5% for rotavirus （X^2 =0.4, P〉0.05）, 8. 3% and 12. 0% for norovirus （X^2= 1. 24, P 〉 O. 05）, 7. 3% and 11. 5% for enteric adenovirus （X^2 = 1.75, P 〉 0. 05）, and 1.6% and 2. 1% for astrovirus （X^2 = 0, P 〉 0. 05 ） . ELISA and PCR had no significant difference for detecting four viruses. These two methods showed good correlation with each other for detection of rotavirus with a Kappa value of 0. 58 and poor agreement for norovirus, enteric adenovirus and astrovirus with a Kappa value of 0. 18, 0. 15 and 0. 27, respectively. Condusions RV is the dominant etiological agent of infantile diarrhea in Shenzben, followed by norovirus and adenovirus. The high rate of mixed viral infection brings clinical concern. ELISA combined with PCR improve the diagnostic sensitivity for norovirus, enteric adenovirus and astrovirus.
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2009年第8期873-876,共4页
Chinese Journal of Laboratory Medicine
关键词
腹泻
婴儿
病毒性疾病
酶联免疫吸附测定
聚合酶链反应
Diarrhea, infantile
Virus diseases
Enzyme-linked immunosorbent assay
Polymerase chain reaction
