手足口病病毒核酸及抗体检测的比较研究及应用  

Comparison study and application of nucleic acid and antibody detection in hand-foot-mouth disease

作　　者：赵云 蔡晶娟 彭程[2] 王紫荆 尹清金 孙照华 牟杨[1] 卢亚陵[1] 蒋燕 宋晓燕[1] ZHAO Yun;CAI Jingjuan;PENG Cheng;WANG Zijing;YIN Qingjin;SUN Zhaohua;MOU Yang;LU Yaling;JIANG Yan;SONG Xiaoyan(Chengdu Children′s Specialized Hospital,Chengdu,Sichuan 610015,China;Guang′an Municipal People′s Hospital,Guang′an,Sichuan 638001,China;Chengdu Municipal Women′s and Children′s Central Hospital,Chengdu,Sichuan 610091,China)

机构地区：[1]成都儿童专科医院,四川成都610015 [2]四川省广安市人民医院,四川广安638001 [3]成都市妇女儿童中心医院,四川成都610091

出　　处：《国际检验医学杂志》2020年第14期1678-1681,共4页International Journal of Laboratory Medicine

基　　金：四川省卫生和计划生育委员会科研课题(17PJ267)。

摘　　要：目的评价核酸与血清学抗体检测在手足口病诊断及防控中的应用价值。方法对2017年5月至2019年2月成都儿童专科医院收治的手足口病患儿进行肠道病毒71型(EV71)及柯萨奇病毒A16型(CA16)核酸及抗体检测,选取任意一项结果阳性的患儿(290例)作为后续研究对象。治疗2周复诊时再次进行CA16、EV71核酸和抗体检测,分别计算患儿在初诊和病程2周复诊时两种检测方法的检出率。结果初诊患儿EV71与CA16核酸检出率为33.8%(98例),EV71与CA16血清学抗体检出率为84.5%(245例),两种检测方法检出率比较,差异有统计学意义(P<0.05)。两种方法联合检测在初诊患儿中的检出率为98.6%。两种检测方法在不同年龄初诊患儿中的检出率比较,1~5岁年龄段差异有统计学意义(P<0.05);两种检测方法在不同年龄复诊患儿(病程2周)中的检出率比较,差异无统计学意义(P>0.05)。初诊患儿与复诊患儿的核酸检出率比较,差异有统计学意义(P<0.05);初诊患儿与复诊患儿的血清学抗体检出率差异无统计学意义(P>0.05)。结论核酸检测有助于了解患儿恢复期病毒复制情况,对确定手足口病患儿在病程2周后是否仍需要延长隔离时间以及准确制订隔离期具有较大意义。病毒核酸与抗体联合检测可显著提高检出率,具有较高的临床应用价值。Objective To evaluate the application values of nucleic acid and serological antibody detection in the diagnosis,prevention and control of hand-foot-mouth disease(HFMD).Methods The nucleic acid and antibodies of enterovirus 71(EV71)and coxsackievirus A16(CA16)were detected among the children patients with HFMD in Chengdu Children′s Specialized Hospital.Then 290 cases of single result positive were selected as the follow up study subjects.The nucleic acid and antibodies of EV71 and CA16 were re-detected in subseguent visiting after 2-week disease course.The detection rate by the two detection methods was calculated in the initial diagnosis and in subseguent visiting after 2-week disease course respectively.Results The detection rate of EV71 and CA16 in the children patients with initial diagnosis was 33.8%(98 cases),and the detection rate of serological antibodies of EV71 and CA16 was 84.5%(245 cases).The detection rate had statistical difference between the two detection methods(P<0.05).the detection rate in the combined detection of the two methods among the children patients with initial diagnosis was 98.6%.The detection rate comparison among different ages of children patients with initial diagnosis showed that the difference in the age period of 1-5 yeas old was statistically significant(P<0.05);the detection rates of the two detection methods had no statistical difference among different ages of subsequent visiting(2 weeks of disease course)(P>0.05).The nucleic acid detection rate had statistical difference between the children patients with initial diagnosis and the children patients with subsequent visiting(P<0.05).There was no statistically significant difference in serological antibody detection rate between the initially diagnosed children and revisited children(P>0.05).Conclusion The nucleic acid detection is helpful to understand the replication situation of the virus in children′s convalescence,which has the greater significance for determining whether needing to prolong the isolation time after

关 键 词：手足口病 核酸检测 血清学抗体检测 

分 类 号：R725.1[医药卫生—儿科] R512.5[医药卫生—临床医学]