Tubex快速检测法与肥达试验在伤寒、甲型副伤寒诊断中的应用比较  

Comparison between Tubex rapid detection method and Widal test in the diagnosis of typhoid and paratyphoid A

作　　者：王鸣柳[1] 廖和壮[1] 杨进[1] 谭冬梅[1] 曾竣[1] 权怡[1] 黄君[1] WANG Ming-liu;LIAO He-zhuang;YANG Jin;TAN Dong-mei;ZENG Jun;QUAN Yi;HUANG Jun(Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning,Gucmgxi 530028,China)

机构地区：[1]广西壮族自治区疾病预防控制中心,广西南宁530028

出　　处：《应用预防医学》2021年第5期385-389,共5页Applied Preventive Medicine

基　　金：国家重大科技专项(2018ZX10713003-002-004);中美EID项目子项目6(6NU2GGH000961-05-01);广西医疗卫生重点科研课题(重200950)。

摘　　要：目的评估肥达试验和Tubex试验在伤寒、甲型副伤寒诊断中的应用价值。方法采集2006—2012年广西伤寒、甲型副伤寒常规监测和暴发疫情中的164例确诊病例血清,应用肥达试验、Tubex-TF试验和Tubex-PA试验进行伤寒、甲型副伤寒血清抗体检测;分别计算3种试验血清检测结果的灵敏度、特异度、假阳性率、假阴性率、约登指数和Kappa值等指标,对检测结果进行评估。结果以病原分离为金标准,对106例病原分离阳性的伤寒血清进行检测,Tubex-TF试验的灵敏度为66.98%,特异度为78.93%,阳性预测值为0.225,阴性预测值为0.963;对58例病原分离阳性的甲型副伤寒血清进行检测,Tubex-PA试验的灵敏度为70.69%,特异度为91.16%,阳性预测值为0.272,阴性预测值为0.985。病原分离阳性的伤寒及甲型副伤寒病例血清进行肥达试验,阳性率分别为44.34%和22.41%。病原分离和Tubex-TF试验检测为伤寒阳性的血清,Tubex-PA试验同时检测为阳性的检出率为2.82%;病原分离与Tubex-PA试验检测为甲型副伤寒阳性的血清,Tubex-TF试验同时检测为阳性的检出率为31.71%。结论疾病暴发或流行时,可考虑采用简单易行的Tubex试验作为辅助诊断伤寒、副伤寒的方法,有利于疫情的早期发现和防控。Objective To evaluate the application value of Widal test and Tubex detection on diagnosis of typhoid and paratyphoid A. Methods The serum of 164 confirmed cases of typhoid fever and paratyphoid A in Guangxi from 2006 to 2012 during routine surveillance and outbreaks were collected, and the Widal test, Tubex-TF test and Tubex-PA test were used to detect typhoid and paratyphoid A serum antibodies.The results of sensitivity, specificity, false positive rate, false negative rate, Youden index, Kappa value, and other indexes of three test serums were calculated, and test results were evaluated. Results Using pathogen isolation as the gold standard, 106 cases of typhoid serum with positive pathogen isolation were detected.The sensitivity and specificity of Tubex-TF were 66.98% and 78.93%, respectively, with the positive predictive value(PPV) of 0.225 and negative predictive value(NPV) of 0.963. For 58 cases of paratyphoid A serum with positive pathogen isolation,the sensitivity and specificity of Tubex-PA were 70.69% and 91.16%, respectively, with the PPV of 0.272 and NPV of 0.985. The sera of typhoid and paratyphoid A cases with positive pathogen isolation were tested by Widal, and the positive rates were 44.34% and 22.41%, respectively. Pathogen isolation and Tubex-TF test were used to detect typhoid-positive serum, the detection rate of Tubex-PA test being positive at the same time was 2.82%. Pathogen isolation and Tubex-PA test detected positive serum for paratyphoid A, and the detection rate of Tubex-TF test being positive at the same time was 31.71%. Conclusion When a disease breaks out or is epidemic,the simple and easy Tubex test can be used as an auxiliary method to diagnose typhoid and paratyphoid to facilitate the early outbreak detection and prevention.

关 键 词：伤寒 甲型副伤寒 血清学检测 

分 类 号：R516.3[医药卫生—内科学]