布鲁菌病4种血清学检测方法的临床诊断应用分析  

Analysis of the four serologicaltests for clinical diagnosis of brucellosis

作　　者：吴飞 范蒙光 塔娜 尉瑞平 宋利桃 李晓燕 郭威 张文强 WU Fei;FAN Mengguang;TA Na;YU Ruiping;SONG Litao;LI Xiaoyan;GUO Wei;ZHANG Wenqiang(School of Public Health,Baotou Medical College,Inner Mongolia Autonomous Region 014040,China;不详)

机构地区：[1]包头医学院公共卫生学院,内蒙古自治区014040 [2]内蒙古自治区综合疾病预防控制中心

出　　处：《医学动物防制》2023年第6期522-525,共4页Journal of Medical Pest Control

基　　金：内蒙古自然科学基金项目(202201165)。

摘　　要：目的观察布鲁菌病(brucellosis,简称“布病”)的4种实验室检测方法,探讨其在布病诊断中的临床意义。方法选取2022年1—6月在内蒙古自治区综合疾病预防控制中心布病门诊就诊的119例患者为病例组,同期97例健康体检人员为对照组。采用虎红平板凝集试验(rose bengal plate agglutination test,RBPT)、荧光偏振试验(fluorescence polarization,FPA)、间接酶联免疫吸附试验(indirect enzyme-linked immunosorbent assay,iELISA)、血清凝集试验(serum agglutination test,SAT)进行布病血清学检测,比较RBPT、iELISA、FPA和确诊方法SAT的一致性,分析其灵敏度、特异度、漏诊率和误诊率。结果以SAT为金标准,SAT与RBPT、iELISA、FPA的一致性比较符合(Kappa=0.759、0.898、0.842)。iELISA的灵敏度(94.02%)高于FPA(93.04%)和RBPT(90.18%),漏诊率(5.98%)低于FPA(6.96%)和RBPT(9.82%);iELISA的特异度(95.96%)高于FPA(91.09%)和RBPT(85.58%),误诊率(4.04%)低于FPA(8.91%)和RBPT(14.42%)。以确诊病例为金标准,灵敏度SAT(95.80%)>iELISA(94.96%)>FPA(93.28%)>RBPT(90.76%),特异度SAT(100.00%)>iELISA(96.91%)>FPA(92.78%)>RBPT(86.60%)。结论布病实验室检测FPA和iELISA灵敏度较好、特异度较高,采用FPA、IELISA初筛,SAT确诊相结合,能简便、迅速、精确地对布病进行诊断。多种血清学检测联合应用,能降低布病误诊、漏诊率,提高其诊断水平。Objective To observe four laboratory tests for brucellosis and to explore their clinical significance in the diagnosis of brucellosis.Methods The 119 patients who were treated in the outpatient clinic of brucellosis in the Center for Comprehensive Disease Control and Prevention of Inner Mongolia Autonomous Region from January to June 2022 were selected as the case group,and 97 healthy persons as the control group during the same period.Serological tests for brucellosis were performed using the rose bengal plate agglutination test(RBPT),the fluorescence polarization test(FPA),indirect indirect enzyme-linked immunosorbent assay(iELISA)and the serum agglutination test(SAT).The consistency of RBPT,iELISA,FPA and SAT were compared,and the sensitivity,specificity,misdiagnosis rate and underdiagnosis rate were analyzed.Results Taking SAT as the gold standard,the consistency of SAT and RBPT,iELISA and FPA in the rapid detection of brucellosis was consistent(Kappa=0.759,0.898,0.842).The sensitivity of iELISA(94.02%)was higher than that of FPA(93.04%)and RBPT(90.18%),and the missed diagnosis rate(5.98%)was lower than that of FPA(6.96%)and RBPT(9.82%).The specificity of iELISA(95.96%)was also higher than that of FPA(91.09%)and RBPT(85.58%),and the misdiagnosis rate(4.04%)was lower than that of FPA(8.91%)and RBPT(14.42%).Taking the confirmed cases as the gold standard,the sensitivity of SAT(95.80%)was higher than that of iELISA(94.96%),FPA(93.28%)and RBPT(90.76%),while the specificity SAT(100.00%)was higher than that of iELISA(96.91%),FPA(92.78%)and RBPT(86.60%).Conciusion For laboratory testing methods of brucellosis,FPA and iELISA have good sensitivity and specificity.The combination of FPA and iELISA for primary screening and SAT for confirmatory diagnosis provids a simple,rapid and accurate diagnosis of brucellosis.The multiple serological tests should be combined to detect brucellosis,so as to reduce the probability of misdiagnosis and missed diagnosis rate of brucellosis and improve the diagnostic level of brucellosis.

关 键 词：布鲁菌病 检测 荧光偏振试验 间接酶联免疫吸附试验 血清学检测 分析 

分 类 号：R516.7[医药卫生—内科学]