摘要
目的评价胶体金和免疫渗滤法在筛查临床甲型流感病毒感染中的诊断效率。方法收集2009.6～2009.10我院发热门诊流感样病例咽拭子标本297例,分别用免疫渗滤法和胶体金法进行快速检测,同时采用实时荧光定量PCR和测序进行验证,以评价两种方法的诊断效率。结果在实时荧光定量PCR法及测序证实为甲型流感166份,其中免疫渗滤法灵敏度为54.82%(91/166),与PCR法符合率为66.67%,Kappa值为0.35;胶体金法灵敏度为4.22%(7/166),符合率为45.79%,Kappa值为0.02;在131份甲型流感病毒阴性的标本中,免疫渗滤法特异性为81.68%(107/131),胶体金法特异性为98.47%(129/131);在实时荧光定量PCR检测为甲型H1N1阳性的99份标本中,免疫渗滤法检出率为67.3%,胶体金检出率为5.1%;在两种方法结果不符合108份标本中,免疫渗滤法阳性而胶体金阴性的标本107份,实时荧光定量PCR法并序列测定显示其中84份为甲型流感病毒阳性,23份为阴性;免疫渗滤法阴性而胶体金阳性的1份标本,甲型流感病毒实时荧光PCR检测为阴性。免疫渗滤法在甲型流感病毒的检出率和与PCR方法的符合率方面明显高于胶体金法(P<0.05)。结论免疫渗滤法在甲型流感病毒筛查中优于胶体金法,显示出良好的临床应用前景。
Objective To evaluate the diagnostic efficiency of colloidal gold and dot ELISA rapid tests in clinical screening of influenza A virus.Methods The pharyngeal swabs were collected from 297 outpatients suspected of influenza between June and October,2009 for detection with colloid gold and dot ELISA rapid test,with real-time PCR as the golden methods.The discrepant results of colloid gold and dot ELISA methods were confirmed by sequencing,and the diagnostic efficiency of the two methods was evaluated.Results Among the 166 samples with influenza A virus infection as confirmed by real-time PCR and sequencing,the diagnostic sensitivity of dot ELISA and colloid gold methods was 54.82%（91/166） and 4.22%（7/166）,respectively.The total concordance rate with PCR was 66.67%（Kappa value of 0.35）.Among the 133 samples negative for influenza A virus,the specificity of dot ELISA and colloid gold methods was 81.68%（107/131） and 98.47%（129/131）,respectively,with a total concordance rate with PCR of 45.79%（Kappa value 0.02）.Of the 99 H1N1 influenza samples confirmed by real-time PCR,the detection rate of dot ELISA was 67.3%,whereas that of colloid gold was 5.1%.Out of the 107 dot ELISA-positive but colloid gold-negative samples,84 were confirmed to be influenza A virus-positive by real-time PCR and sequencing.One sample negative fordot ELISA but positive for colloid gold test was confirmed to be influenza A virus-negative.The detection rate and diagnostic concordance rate for influenza A virus by dot ELISA were significantly higherthan those of colloid gold（P0.05）.Conclusion Dot ELISA is betterthan colloid gold in influenza A virus detection and shows great prospect in clinical screening.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2010年第10期2267-2269,共3页
Journal of Southern Medical University
基金
国家自然科学基金(30972523)~~
关键词
甲型流感病毒
胶体金
免疫渗滤
实时荧光PCR
influenza A virus colloid gold dot enzyme-linked immunosorbent assay real-time polymerase chain reaction
