酶联免疫吸附试验与实时荧光定量PCR法在麻疹和风疹检测中的比较分析  

Comparative analysis of enzyme linked immunosorbent assay and RT-PCR in measles and rubella detection

作　　者：王慧晶[1] 李爱军[1] 王雨[1] 胡玉婕 石岩 张子赫 WANG Hui-jing;LI Ai-jun;WANG Yu;HU Yu-jie;SHI Yan;ZHANG Zi-he(Pingdingshan Center for Disease Control and Prevention,Henan 467000,China)

机构地区：[1]平顶山市疾病预防控制中心,河南467000

出　　处：《医学动物防制》2022年第3期246-249,共4页Journal of Medical Pest Control

基　　金：河南省2019年中央财政重大公共卫生项目(疾控部分)(豫财社[2019]85号)。

摘　　要：目的比较分析麻疹、风疹疑似病例标本的酶联免疫吸附试验(enzyme linked immunosorbent assay, ELISA)与实时荧光定量PCR法(real-time quantitative PCR,RT-PCR)的检测结果,为麻疹、风疹的尽早确诊和检测方法选择提供科学依据。方法应用ELISA法检测平顶山市2015—2019年531例疑似病例的血清标本中的IgM抗体,RT-PCR法检测咽拭子标本中的核酸。结果 ELISA法检出血清麻疹IgM阳性147例,阳性率为27.68%;检出血清风疹IgM阳性24例,阳性率为4.52%。RT-PCR法检测咽拭子中麻疹病毒核酸阳性194例,阳性率为36.53%;检测风疹病毒核酸阳性46例,阳性率为8.66%。两种方法检测阳性率差异均有统计学意义(χ^(2)=9.54、7.40,P=0.002、0.007)。ELISA法灵敏度分别为69.34%、50.91%,RT-PCR法灵敏度分别为91.51%、83.64%,差异有统计学意义(χ^(2)=26.62、8.03,P<0.01、0.004)。出疹3 d内,RT-PCR法检测阳性率与ELISA法比较,差异均有统计学意义(χ^(2)=8.09、4.66,P=0.004、0.031)。无免疫史或免疫史不详者两方法检出阳性率差异均有统计学意义(χ^(2)=11.36、4.08,P=0.001、0.043)。结论麻疹和风疹利用RT-PCR法检测阳性率和灵敏度均高于ELISA法,可为两者的临床诊断提供科学的确诊依据。Objective To compare enzyme linked immunosorbent assay(ELISA) and real-time quantitative PCR(RT-PCR) in specimens of testing suspected measles and rubella cases, and to provide scientific basis for confirmation and selection on detection methods for measles and rubella at earliest convenience.Methods IgM antibodies in serum specimens of 531 suspected cases was detected by ELISA in Pingdingshan from 2015 to 2019,and nucleic acids from throat swab specimens were detected by RT-PCR.Results ELISA was used to detect 147 cases of measles IgM with the positive rate of 27.68%;24 cases of positive IgM of serum rubella with positive rate was 4.52% was found.194 positive measles virus nucleic acid cases with positive rate of 36.53% was detected to be with RT-PCR;46 cases of rubella virus nucleic acid were detected to be positive with the positive rate of 8.66%.The difference in the positive rate of such two methods was statistically significant(χ^(2)=9.54,7.40,P=0.002,0.007).The sensitivity of ELISA was 69.34% and 50.91% respectively, and that of RT-PCR was 91.51% and 83.64%.The difference was statistically significant(χ^(2)=26.62,8.03,P<0.01,0.004) the difference in the positive rate with RT-PCR and that with ELISA was statistically significant(χ^(2)=8.09,4.66,P=0.004,0.031)within 3 days after rash onset.The difference in the positive rate of two methods in patients without or unknown history of immunization was statistically significant(χ^(2)=11.36,4.08,P=0.001,0.043).Conclusion The positive rate and sensitivity of measles and rubella detected by RT-PCR were both significantly higher than those of ELISA,being eligible to provide a scientific basis for clinical iagnosis of measles and rubella.

关 键 词：麻疹 风疹 酶联免疫吸附试验 实时荧光定量PCR 检测 比较 分析 

分 类 号：R511.1[医药卫生—内科学] R511.2[医药卫生—临床医学]