新生儿咽拭子检测在诊断单纯疱疹病毒先天性感染中的意义  

The significance of throat swab testing in the diagnosis of neonatal herpes simplex virus congenital infection

作　　者：任鹏[1] 姚娟[1] 金艳[2] 葛俊[1] 李法锦[1] 汪晓婷[1] 吉阳[1] 赵蕾[1] 江龙凤[1] 陈敬贤[3] 王明丽[1] 

机构地区：[1]安徽医科大学微生物学教研室,合肥230032 [2]合肥市妇幼保健院,合肥230001 [3]美国哥伦比亚大学病理与细胞生物学系,纽约10032

出　　处：《安徽医科大学学报》2012年第7期813-816,共4页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:30872253);安徽省科技厅科技攻关项目(编号:08010302179)

摘　　要：目的以巢式PCR检测新生儿脐带血中单纯疱疹病毒1型(HSV-1)gD基因和HSV-2 gG基因并用测序确认的结果为参比,分析利用新生儿咽拭子检测相应病毒基因在诊断新生儿HSV先天性感染中的意义。方法采集顺产新生儿抗凝脐带血35份,同时采集咽拭子35份。采用检测HSV-1 gD基因和HSV-2 gG基因的PCR法检测新生儿脐带血和咽拭子标本DNA,阳性扩增结果确认后,比较咽拭子检测与脐带血检测结果,以及咽拭子检测特异性、灵敏度、阳性预测值和阴性预测值4个指标,分析新生儿咽拭子检测能否为诊断HSV先天性感染提供依据。结果 35份脐带血中HSV-1阳性率28.6%(10/35),咽拭子HSV-1阳性率25.7%(9/35),两者差异无统计学意义。脐带血中HSV-2阳性率22.8%(8/35),咽拭子HSV-2阳性率28.6%(10/35),两者差异无统计学意义。HSV-1两种标本检测一致率68.6%;HSV-2两种标本一致率77.1%。咽拭子HSV-1、HSV-2检测灵敏度分别为40.0%和62.5%,特异性分别为80.0%和84.6%,阳性预测值分别为44.4%和50.0%,阴性预测值分别为76.9%和88.0%。结论以新生儿脐带血单核细胞中HSV-1 gD基因和HSV-2 gG基因检测结果为参比,新生儿咽拭子检测与脐带血检测具有较高的一致性,表明咽拭子检测用于新生儿HSV先天性感染诊断具有重要的临床应用价值。Objective To detect and confirm the gene-sequence of herpes simplex virus 1 （ HSV-1 ） gD gene and HSV-2 gG gene from the cord blood, and explore the significance of HSV-I gD gene and HSV-2 gG gene of neonatal throat swabs for diagnosis of congenital HSV infection. Methods 35 cord blood and 35 throat swabs of birth neonatal were collected. HSV-1 gD gene and HSV-2 gG gene in cord blood and throat swab samples were detected by PCR. After confirming the DNA-positive amplification results of throat swab and cord blood, the detected results of throat swab and cord blood, specificity, sensitivity, positive predictive value and negative predictive value were compared. Weather neonatal throat swab testing could provide the basis for the diagnosis of HSV congenital infec- tion. Results Cord blood HSV-1 positive rate was 28.6% （ 10/35 ）, throat swab HSV-1 positive rate was 25.7% （9/35）, there was not statistically significant difference. Cord blood HSV-2 positive rate was 22. 8% （8/35） , throat swab HSV-2 positive rate was 28. 6% （ 10/35 ）, there was not statistically significant difference. Two speci- mens HSV-1 consistent rate was 68.6% （24/35） , and HSV-2 consistent rate was 77.1%. Throat swab HSV-1, HSV-2 detection sensitivity were 40. 0% and 62.5%, specificity were 80% and 84. 6%, positive predictive values were 44.4% and 50% , negative predictive values were 76.9% and 88% ,respectively. Conclusion The test results of cord blood and throat swab have a high consistency, which suggested that the use of neonatal throat swab has important clinical value for the diagnosis of HSV congenital infection.

关 键 词：单纯疱疹病毒 脐带血 咽拭子 先天性感染 

分 类 号：R722.03[医药卫生—儿科]