免疫层析法与PCR法对妊娠期妇女B族链球菌的检测效能比及阳性病例影响因素分析  

Analysis of the Detection Efficiency Ratio of Immunochromatography and PCR for Group B Streptococcus in Pregnant Women and the Influencing Factors of Positive Cases

作　　者：金娴 樊春卉 朱平安 唐红 吴意 谭萍 陈芳 黄晓彤 JIN Xian;FAN Chunhui;ZHU Ping’an;TANG Hong;WU Yi;TAN Ping;CHEN Fang;HUANG Xiaotong(Shenzhen Yantian District People’s Hospital,Shenzhen 518081,China;不详)

机构地区：[1]广东省深圳市盐田区人民医院,广东深圳518081

出　　处：《中国医学创新》2020年第11期44-48,共5页Medical Innovation of China

基　　金：深圳市盐田区科技计划项目(20170204)。

摘　　要：目的:探讨免疫层析法、实时荧光定量PCR法对妊娠期妇女B族链球菌的检测效能比,并分析阳性患者相关影响因素。方法:选择2018年4月-2019年7月于本院产检的妊娠晚期孕妇643例为研究对象,采集其阴道-直肠分泌物作为样本,分别用免疫层析法、实时荧光定量PCR法进行检测,检测前均对样本进行选择性肉汤培养基增菌。统计免疫层析法及PCR法的检测结果,并以细菌培养法为金标准,对各检验方法的灵敏度、特异度、准确性进行比较。对阳性患者及阴性患者的相关资料进行单因素及多因素Logistic回归分析。结果:免疫层析法GBS检测阳性率为11.8%,PCR法阳性检测率为11.4%,虽均高于增菌细菌培养法的9.5%,但差异均无统计学意义(P>0.05)。免疫层析法检测GBS的灵敏度63.9%,特异度93.6%,准确性90.8%。PCR法检测GBS的灵敏度73.8%,特异度95.2%,准确性93.2%。免疫层析法与PCR法阳性检出率、灵敏度、特异度、准确性比较,差异均无统计学意义(P>0.05)。单因素分析结果显示,阳性患者与阴性患者的年龄>32岁、体重指数>24 kg/m^2、妊娠合并糖尿病、妊娠期阴道炎、甲状腺功能减退、经产、流产史比较,差异均有统计学意义(P<0.05)。Logistic回归分析显示,年龄>32岁、妊娠合并阴道炎、妊娠合并糖尿病、甲状腺功能减退、经产、流产史均为B族链球菌感染的独立危险因素(P<0.05)。结论:增菌后免疫层析法与PCR法对妊娠期妇女B族链球菌的阳性检出率、灵敏度、特异度、准确性基本一致,免疫层析法操作简单,用时短,PCR法可批量操作,适应性也广,临床可根据受检者具体情况选择合理的检测方式。临床对高龄、合并阴道炎、合并糖尿病、甲状腺功能减退、经产、流产史的孕妇应加强B族链球菌的检测。Objective:To investigate the detection efficiency ratio of group B streptococcus in pregnant women by immunochromatography and real-time quantitative PCR,and to analyze the influencing factors of positive patients.Method:A total of 643 pregnant women in the third trimester who underwent prenatal examination in our hospital from April 2018 to July 2019 were selected as the study subjects.The vaginal-rectal secretions were collected as samples.Immunochromatographic method and real-time fluorescence quantitative PCR method were used for detection.The samples were selectively enriched by broth medium before detection.The results of immunochromatography and PCR were analyzed,and using bacterial culture as the gold standard,the sensitivity,specificity and accuracy of each method were compared.Univariate and multivariate Logistic regression analysis was performed on the data of positive and negative patients.Result:The positive rate of GBS by immunochromatography was 11.8%,and the positive rate of PCR was 11.4%,both of which were higher than 9.5% of the cultured bacteria,but the differences were not statistically significant (P>0.05).The sensitivity,specificity and accuracy of GBS were 63.9%,93.6% and 90.8% by immunochromatography.The sensitivity,specificity and accuracy of GBS were 73.8%,95.2% and 93.2% by PCR.Comparing the positive detection rate,sensitivity,specificity and accuracy of the immunochromatographic method and the PCR method,the differences were not statistically significant (P>0.05).The results of single factor analysis showed that the age of positive patients and negative patients were over 32 years old,body mass index > 24 kg/m^2,gestational diabetes mellitus,gestational vaginitis,hypothyroidism,menstrual and abortion history,the differences were statistically significant (P<0.05).Logistic regression analysis showed that age over 32 years old,pregnancy with vaginitis,pregnancy with diabetes mellitus,hypothyroidism,labor and abortion history were all independent risk factors for group B streptococcal inf

关 键 词：免疫层析 PCR 妊娠 B族链球菌 

分 类 号：R714.251[医药卫生—妇产科学]