3种布鲁氏菌病诊断方法的比较与分析  

Comparison and Analysis of Three Diagnostic Methods for Brucellosis

作　　者：李玉京[1] 贾芹香 张会青[2] LI Yujing;JIA Qinxiang;ZHANG Huiqing(Department of Clinical Laboratory,Shouguang Center for Disease Control and Prevention,Shouguang Shandong 262700,China;Department of Quality Management,Shouguang Center for Disease Control and Prevention,Shouguang Shandong 262700,China)

机构地区：[1]寿光市疾病预防控制中心检验科,山东寿光262700 [2]寿光市疾病预防控制中心质量管理科,山东寿光262700

出　　处：《中国卫生标准管理》2025年第4期15-18,共4页China Health Standard Management

摘　　要：目的比较虎红平板凝集试验(rose-bengal plate agglutination test,RBT)、试管凝集试验(serum agglutination test,SAT)和实时荧光定量聚合酶链式反应(quantitative realtime PCR,qPCR)各方法检测结果的差异,为布鲁氏菌病病因预防和检测提供一定理论依据。方法 选取2022年1月—2023年12月寿光市疾病预防控制中心收集的各乡镇医院送检的血清标本共1 890份,同时采用RBT、SAT和qPCR 3种方法对1 890份样本进行检测,计算RBT、SAT、qPCR与RBT联合qPCR的检测结果。结果 SAT阳性90份,RBT阳性103份,qPCR阳性100份,RBT联合qPCR阳性91份。以SAT作为“金标准”,RBT与SAT的检出率一致性较高(k=0.833,P <0.05),qPCR与SAT的检出率一致性也较高(k=0.871,P <0.05),而RBT联合qPCR与SAT的检出率一致性极高(k=0.978,P> 0.05)。RBT敏感度为94.44%(85/90),特异度为99.00%(1 782/1 800)。qPCR敏感度为96.67%(87/90),特异度为99.28%(1 787/1 800)。RBT联合q PCR敏感度97.78%(88/90),特异度99.83%(1 797/1 800)。不同方法在敏感度上比较,差异无统计学意义(P> 0.05);但在特异度上差异有统计学意义(P <0.05)。结论 RBT联合qPCR具有最高的敏感度和特异度,且方法操作简便。因此,RBT联合qPCR适合大面积筛查布鲁氏菌病,再使用“金标准”SAT进行确诊,对布鲁氏菌病的早期诊断具有重要意义。Objective To compare the results of rose-bengal plate agglutination test(RBT),serum agglutination test(SAT)and quantitative real-time PCR(qPCR),and to provide a theoretical basis for the prevention and detection of Brucellosis.Methods A total of 1890 serum samples from township hospitals collected by Shouguang Center for Disease Control and Prevention from January 2022 to December 2023 were selected, and 1 890 samples were tested by RBT, SAT and qPCR, and the detection results of RBT, SAT, qPCR and RBT combined with qPCR were calculated. Results A total of 90 positive SAT, 103 RBT positive, 100 copies of qPCR positive, and 91 copies of RBT and qPCR positive. Taking SAT as the "gold standard", the consistency between RBT and SAT was high (k =0.833, P < 0.05), the consistency between qPCR and SAT was also high (k =0.871, P < 0.05), and the consistency between RBT combined with qPCR and SAT was very high (k =0.978, P > 0.05). The sensitivity and specificity of RBT were 94.44% (85/90) and 99.00% (1 782/1 800). The sensitivity and specificity of qPCR were 96.67% (87/90) and 99.28% (1 787/1 800). The sensitivity of RBT combined with qPCR was 97.78% (88/90), and the specificity was 99.83% (1 797/1 800). There was no significant difference in sensitivity between different methods (P > 0.05). However, the difference in specificity was statistically significant (P < 0.05). Conclusion RBT combined with qPCR has the highest sensitivity and specificity, and the method is simple to operate. Therefore, RBT combined with qPCR is suitable for large-area screening of Brucellosis , and then the "gold standard" SAT is used for diagnosis, which is of great significance for the early diagnosis of Brucellosis.

关 键 词：布鲁氏菌病 敏感度 特异度 虎红平板凝集试验 试管凝集试验 实时荧光定量聚合酶链式反应 

分 类 号：R446[医药卫生—诊断学]