摘要
目的 研究虎红平板凝集试验(Rose-Bengal plate agglutination test, RBPT)、标准试管凝集试验(standard tube agglutination test, SAT)、酶联免疫吸附(enzyme-linked immunosorbent assay, ELISA)方法在布鲁氏菌病中检测的特性及诊断效能。方法 选取兴安盟人民医院2020年3月—2021年5月接诊的且有完整记录的489例疑似布鲁氏菌病患者。以接触史+临床症状+血清学检测/布鲁氏菌分离培养为诊断金标准,分析SAT、RBPT和ELISA对布鲁氏菌病的诊断价值。结果 489例疑似患者确诊阳性183例(37.42%),而RBPT、ELISA、SAT分别检出阳性234例(47.85%)、148例(30.27%)、195例(39.88%);RBPT诊断布鲁氏菌病的灵敏度、特异度、阳性预测值、阴性预测值、准确度分别为95.08%、80.39%、74.36%、96.47%、85.89%,ELISA诊断布鲁氏菌病的灵敏度、特异度、阳性预测值、阴性预测值、准确度分别为78.69%、98.69%、97.30%、88.56%、91.21%,SAT诊断布鲁氏菌病的灵敏度、特异度、阳性预测值、阴性预测值、准确度分别为98.36%、95.10%、92.31%、98.98%、96.32%,其中RBPT诊断的灵敏度高于ELISA,特异度、准确度低于ELISA(P<0.05);SAT诊断的灵敏度、准确度高于ELISA,特异度低于ELISA(P<0.05);SAT诊断的灵敏度与RBPT比较无明显差异,但特异度和准确度均高于RBPT(P<0.05)。结论 RBPT、SAT诊断布鲁氏菌病灵敏度均高,而ELISA诊断特异度较高,现场检测中可用高灵敏度且操作便捷的RBPT初筛,再用其他两种方法进行复核,从而进一步提高布鲁氏菌病诊断的效率和准确度。
Objective To study the characteristics and diagnostic efficacy of Rose-Bengal plate agglutination test(RBPT), standard-tube agglutination test(SAT) and enzyme-linked immunosorbent assay(ELISA) in the diagnosis ofbrucellosis.Methods A total of 489 suspected brucellosis patients with complete records, who admitted to Xing’anmengPeople’s Hospital from March 2020 to May 2021, were selected as the subjects. The diagnostic value of SAT, RBPT and ELISAfor brucellosis was analyzed with exposure history + clinical symptoms + serological test/brucellosis isolation and culture as thegold standard.Results Of the 489 suspected patients, 183(37.42%) were diagnosed with brucellosis, while 234(47.85%),148(30.27%) and 195(39.88%) were positive by RBPT, ELISA and SAT, respectively. The sensitivity, specificity, positivepredictive value, negative predictive value, and accuracy of RBPT in the diagnosis of brucellosis were 95.08%, 80.39%,74.36%, 96.47%, and 85.89%, respectively;the values of the above parameters for ELISA were 78.69%, 98.69%, 97.30%,88.56%, and 91.21%, respectively;those values of SAT were 98.36%, 95.10%, 92.31%, 98.98%, and 96.32%, respectively.The sensitivity of RBPT was significantly higher than ELISA, but the specificity and accuracy were significantly lower thanELISA(all P<0.05). The sensitivity and accuracy of SAT diagnosis were significantly higher than ELISA, but the specificity wassignificantly lower than ELISA(all P<0.05). There was no significant difference between SAT and RBPT in the sensitivity ofdiagnosis, but the specificity and accuracy were significantly higher than those of RBPT(P<0.05).Conclusion RBPT andSAT have high sensitivity in diagnosis of brucellosis, while ELISA has high specificity in diagnosis. RBPT with high sensitivityand convenient operation can be used for primary screening in field detection, and then the other two methods can be used forrechecking, so as to further improve the efficiency and accuracy of diagnosis of brucellosis.
作者
李树军
张玉龙
马龙
张静
祖建兵
LI Shu-jun;ZHANG Yu-long;MA Long;ZHANG Jing;ZU Jian-bing(Department of Clinical Laboratory,Xing'anmeng People's Hospital,Xing'anmeng,Inner Mongolia 137400,China)
出处
《中国热带医学》
CAS
2022年第11期1078-1081,共4页
China Tropical Medicine
基金
兴安盟科技计划项目。
