山东省泰安市2015—2019年输入性疟疾病例实验室诊断与复核结果分析  

Analysis on laboratory diagnosis efficacy and reexamination of the results for imported malaria cases in Tai’an City of Shandong Province during 2015-2019

作　　者：张新峰[1] 刘运强[1] 张志君[1] 许艳[2] 李瑾[2] 张本光[2] ZHANG Xin-feng;LIU Yun-qiang;ZHANG Zhi-jun;XU Yan;LI Jin;ZHANG Ben-guang(Tai'an Center for Disease Control and Prevention,Shandong Province,Tai'an 271000.China;Shandong Institute of Parasitic Diseasesf Shandong First Medical University&Shandong Academy of Medical Sciences,Jining 272033,China)

机构地区：[1]山东省泰安市疾病预防控制中心,泰安271000 [2]山东省寄生虫病防治研究所,山东第一医科大学(山东省医学科学院),济宁272033

出　　处：《中国寄生虫学与寄生虫病杂志》2021年第1期129-132,共4页Chinese Journal of Parasitology and Parasitic Diseases

基　　金：山东省自然科学基金(ZR2017YL005);山东预防医学会智飞疾病预防控制技术研究基金(LYH2017-16)。

摘　　要：省、市、县三级实验室分别采用镜检法、胶体金法及巢式PCR法对泰安市2015-2019年输入性疟疾进行诊断与复核。共诊断与复核输入性疟疾病例122例,其中镜检法和胶体金法的符合率分别为94.3%(115/122)和95.9%(117/122),镜检阴性率为5.7%(7/122),均为恶性疟;胶体金法阴性率为4.1%(5/122),3例非恶性疟和2例恶性疟阴性,3种检验方法符合率差异有统计学意义(P <0.05)。其中恶性疟和间日疟诊断符合率最高,均达100%,对卵形疟诊断符合率最低,仅为12/18,对4种疟原虫实验室诊断符合率差异有统计学意义(P <0.01)。医疗机构中初诊合格率为94.3%(115/122),市、县级疾病预防控制机构复核合格率分别为97.5%(119/122)和95.1%(116/122),差异无统计学意义(P> 0.05)。今后应继续加强市、县级疟疾实验室镜检人员技能培训,积极开展疟疾核酸检测,以进一步提升医疗及疾病预防控制机构的疟疾诊断水平。The imported malaria cases in Tai ’an City, Shandong Province, during 2015 - 2019 were diagnosed and the results rechecked at Province-, city-, and county-based laboratories using microscopy, nested-PCR, and colloidal gold methods, respectively. A total of 122 imported malaria cases were diagnosed and the results rechecked by the city laboratory. Rechecking the results, the provincial malaria diagnosis reference laboratory confirmed 122 cases positive, among them, the coincidence rate by microscopy, colloidal gold and PCR methods was 94.3%(115/122), 95.9%(117/122), and 100%, respectively;7 cases of microscopy negative were falciparum malaria;while of 5 cases of colloidal gold method negative, 2 cases were falciparum, and 3 non-falciparum. There was a significant difference in the coincidence rate among the three examination methods( P < 0.05). In addition, there was a significant difference in the coincidence rate of laboratory diagnosis for four plasmodium species( P < 0.01), among them, the diagnosis coincidence rate for Plasmodium falciparum and P. vivax was highest(100%), whereas the lowest coincidence was seen in P. ovale(12/18). The pass rate of diagnosis at the first visit in medical institutions was 94.3%(115/122), and the pass rate of rechecking at city-level and county-level centers for disease control(CDC) were97.5%(119/122) and 95.1%(116/122), respectively( P > 0.05). It is necessary to further strengthen skill training for laboratory microscopy examiners and actively carry out malaria nucleic acid testing, in order to improve the performance level of diagnosis in medical institutions and CDCs.

关 键 词：疟疾 输入性 镜检法 巢式PCR法 胶体金法 符合率 

分 类 号：R531.3[医药卫生—内科学]