机构地区:[1]山东大学附属济南市传染病医院检验科,250021
出 处:《中华传染病杂志》2020年第2期99-104,共6页Chinese Journal of Infectious Diseases
摘 要:目的探讨极速实时荧光聚合酶链反应(polymerase chain reaction,PCR)、实时荧光PCR、酶联免疫吸附测定(enzyme-linked immunosorbent assay,ELISA)和胶体金免疫层析法(gold immunochromatography assay,GICA)4种方法检测新型布尼亚病毒的特异度和灵敏度,为发热伴血小板减少综合征的早期诊断提供依据。方法采集2017年6月1日至9月30日山东大学附属济南市传染病医院86例临床诊断为发热伴血小板减少综合征患者的血清样本,分别应用极速实时荧光PCR、实时荧光PCR、ELISA和GICA 4种方法进行检测。统计学分析采用χ^2检验。结果86份患者血清标本中,极速实时荧光PCR、实时荧光PCR、IgM-ELISA、IgG-ELISA、IgM-GICA、IgG-GICA的新型布尼亚病毒阳性分别为82份(95.34%)、79份(91.86%)、41份(47.67%)、8份(9.3%)、19份(22.09%)和3份(3.49%)。极速实时荧光PCR特异度为100%,灵敏度达到1×103拷贝/mL,3次重复扩增试验显示其Ct值变异系数均<2%。在发热伴血小板减少综合征进展的1期、2期、3期病程中,极速实时荧光PCR的阳性检出率为41份(97.62%)、34份(94.44%)、7份(87.50%),实时荧光PCR的阳性检出率为39份(92.86%)、33份(91.67%)、7份(87.50%),在1期和2期两个病程,极速实时荧光PCR阳性检出率略高;IgM-ELISA阳性检出率从1期(28.57%)到3期(87.50%)显著增高,2期、3期与1期相比,差异均有统计学意义(χ^2=8.347、7.561,均P<0.01);IgM-GICA的阳性检出率从1期(14.29%)到2期(33.33%)也有增高,差异有统计学意义(χ^2=3.962,P<0.05),但与其他方法相比,其检出率偏低。1期,实时荧光PCR阳性检出率显著高于ELISA(IgM和IgG)和GICA(IgM和IgG),差异均有统计学意义(χ^2=33.740、55.080、49.010、64.340,均P<0.01)。2期,实时荧光PCR的阳性检出率高于ELISA(IgM和IgG)和GICA(IgM和IgG),差异均有统计学意义(χ^2=7.700、46.720、23.700、50.630,均P<0.01)。3期,极速实时荧光PCR、实时荧光PCR和IgM-ELISA表现出同样高的阳性检出率,�Objective To investigate the specificity and sensitivity of four methods including ultrafastreal-time fluorescence polymerase chain reaction(PCR),real-time fluorescence(RT)-PCR,enzyme-linked immunosorbent assay(ELISA)and gold immunochromatography assay(GICA)for the detection of novel Bunya virus,so as to provide experimental basis for the early diagnosis of severe fever with thrombocytopenia syndrome(SFTS).Methods Serum samples from 86 clinically diagnosis SFTS patients admitted to the Jinan Infectious Diseases Hospital Affiliated to Shandoug University were tested by ultrafast real-time fluorescence PCR,RT-PCR,ELISA and GICA during June 1 to September 30,2017.Chi-square test was used for statistical analysis.Results Among 86 serum samples,the positive rate of novel Bunya virus of ultrafast real-time fluorescence PCR,RT-PCR,IgM-ELISA,IgG-ELISA,IgM-GICA and IgG-GICA were 82(95.34%),79(91.86%),41(47.67%),8(9.3%),19(22.09%)and 3(3.49%),respectively.The specificity of ultrafast real-time fluorescence PCR was 100%,and the sensitivity was 1×103 copies/mL.Repeated amplification test showed that the variation coefficient of the computed tomography value was<2%.During phases one,two and three,the positive rates of ultrafast real-time fluorescence PCR were 41(97.62%),34(94.44%)and 7(87.50%),and RT-PCR were 39(92.86%),33(91.67%)and 7(87.50%),respectively.During phases one and two,the positive rate of ultrafast real-time fluorescence PCR was slightly higher.The positive rate of anti-novel Bunya virus antibody(IgM)tested by ELISA had a significant increase from phase one(28.57%)to phase three(87.50%).There were statistical differences between phase two and phase,as well as between phase three and phase one(χ^2=8.347 and 7.561,respectively,both P<0.01).IgM-GICA also had an increase from phase one(14.29%)to phase two(33.33%)(χ^2=3.962,P<0.01),while it was still lower than the other tests.In phase one,the positive rate of RT-PCR was higher than those of ELISA(both IgM and IgG)and GICA(both IgM and IgG)(χ^2=33.740,55.080,49.0
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