PCR-荧光探针法和核酸序列测定法对呼吸道病原体的检测效能比较及呼吸道病原体的流行特征分析  

Distribution of respiratory viruses among patients with respiratory infection detected by PCR-fluorescent probe and nucleic acid sequencing methods

作　　者：杨文杰 王晓明 童文娟 董学妍 戴卫健 林源吉 王贤军 余道军 YANG Wenjie;WANG Xiaoming;TONG Wenjuan;DONG Xueyan;DAI Weijian;LIN Yuanji;WANG Xianjun;YU Daojun(the Fourth Clinical Medical College,Zhejiang Chinese Medical University,Hangzhou 310053,China;不详)

机构地区：[1]浙江中医药大学四临床医学院,杭州3100053 [2]浙江大学医学院附属杭州市第一人民医院检验科 [3]杭州铭创生命科技有限公司

出　　处：《浙江医学》2023年第16期1704-1708,1717,共6页Zhejiang Medical Journal

基　　金：杭州市农业与社会发展科研重点项目(202204A001);浙江省卫生健康科技计划新技术产品研发项目(2022PY016);杭州市卫生科技计划重大项目(Z2021005)。

摘　　要：目的比较PCR-荧光探针法和核酸序列测定法对呼吸道病原体的检测效能,进一步分析呼吸道病原体的流行特征。方法选择2019年7至12月浙江大学医学院附属杭州市第一人民医院呼吸道感染患者309例,采集鼻咽拭子标本,分别采用核酸序列测定法和PCR-荧光探针法进行同步盲法检测,以核酸序列测定法的检测结果为金标准,分析PCR-荧光探针法检测不同病原体的灵敏度、特异度、阳性预测值和阴性预测值,并分析不同呼吸道病原体的流行特征。结果309例鼻咽拭子标本中,两种方法检测结果不一致或不完全一致的样本共2例,针对不同病原体,PCR-荧光探针法的检测灵敏度均为100.00%,特异度为99.65%~100.00%,阴性预测值均为100.00%,阳性预测值为75.00%~100.00%。309例呼吸道感染患者,人鼻病毒检出率为25.6%(79/309),人腺病毒检出率次之,为11.3%(35/309);学龄前儿童(<6岁)和6~21岁人群检测出18种呼吸道病原体,其中以人鼻病毒检出率最高。结论与核酸序列测定法相比,PCR-荧光探针法检测鼻咽拭子标本中的呼吸道病原体更灵敏、安全、简便、稳定,具有较高的临床应用价值。本院呼吸道感染以人鼻病毒为主。Objective To investigate the viral distribution among patients with respiratory infection detected by PCRfluorescent probe method and nucleic acid sequencing method.Methods A total of 309 patients with respiratory tract infections admitted in the Affiliated Hangzhou First People's Hospital of Zhejiang University School of Medicine were enrolled.The nasopharyngeal swab specimens were collected and tested by nucleic acid sequencing method and PCR-fluorescent probe method,respectively.With the results of nucleic acid sequencing assay considered as the gold standard,the diagnostic efficiency of PCR-fluorescent probe method was analyzed.Results Among the 309 nasopharyngeal swab specimens,there were 2 specimens with inconsistent or incompletely inconsistent results between two methods.For different viruses the sensitivity of the PCR-fluorescent probe method were all 100.00%,the specificity ranged from 99.65%to 100.00%,the negative predictive value were all 100.00%,and the positive predictive value ranged from 75.00%to 100.00%.Among 309 specimens,the detection rate of human rhinovirus(HRV)was the highest(25.6%,79/309),followed by human adenovirus(HADV)(11.3%,35/309).In patients under age of 21 years,18 respiratory pathogens were detected with HRV having the highest detection rate.Conclusion PCR-fluorescent probe method is sensitive,safer,simpler and more stable in detecting respiratory viruses with nasopharyngeal swab specimens and has a high clinical application value.HRV accounts for a highest proportion in respiratory tract infections of the hospital.

关 键 词：呼吸道病原体 核酸序列测定法 荧光探针法 鼻咽拭子 人鼻病毒 人博卡病毒 

分 类 号：R446.5[医药卫生—诊断学]