儿童细小病毒B19感染的诊断方法  

Diagnostic methods of children parvovirus B19 infection

作　　者：曹玉红[1] 张光运[2] 张国成[1] 李如英[1] 曹艳华[3] 

机构地区：[1]第四军医大学西京医院儿科,陕西西安710033 [2]第四军医大学西京医院神经内科,陕西西安710033 [3]济南陆军学院门诊部,山东济南250029

出　　处：《第四军医大学学报》2003年第17期1595-1597,共3页Journal of the Fourth Military Medical University

基　　金：国家自然科学基金 (39870 0 2 1 )

摘　　要：目的 :评价巢式PCR ,ELISA ,间接免疫荧光法 (IIF)诊断B19感染的价值 .方法 :用ELISA及巢式PCR对 12 9例小儿血液病和结缔组织病患者血清进行B19 IgM ,DNA检测 ;用IIF及巢式PCR对 5 0例血液病患者骨髓进行B19抗原及DNA检测 .结果 :病例组 12 9例 ,血清B19 DNA阳性 4 1例 ,阳性率31.8% ;IgM阳性 2 8例 ,阳性率 2 1.7% ;B19 DNA及IgM同时阳性 2 6例 ,仅IgM阳性 2例 ,B19感染率为 33.3% .对照组 5 0例 ,B19 DNA阳性率 2 % ,IgM阳性率 0 % ,B19感染率为 2 % .血液病患者 5 0例骨髓B19 DNA阳性 17例 ,阳性率 34% ;抗原阳性 8例 ,阳性率 16 % .与巢式PCR相比 ,ELISA法的灵敏度为 6 3.4 % ,特异度为 97.7% ,符合率为 86 .8% ,阳性预告值为(+PV)为 92 .8% ,阴性预告值 (-PV)为 85 .1% ;IIF法的灵敏度为 4 7.0 % ,特异度为 10 0 % ,符合率为 82 .0 % ,+PV为10 0 % ,-PV为 78.6 % .结论 :ELISA及IIF敏感性低于巢式PCR ,诊断B19感染时最好同时检测B19AIM: To study the value of nested PCR,ELISA and indirect immunofluoscence (IIF) in diagnosing B19 infection. METHODS: ELISA and nested PCR were used to detect B19 IgM and DNA in the sera of 129 patients with hematonosis and connective tissue diseases and B19 antigen and DNA in the bone marrow samples of 50 patients with hematonosis were examined by IIF and nested PCR. RESULTS : Of the 129 children with hematonosis and connective tissue diseases, 41 patients were sera B19 DNA positive and 28 were IgM positive, with a positive rate of 31.8% (41/129)and 21.7% (28/129) respectively. The infection rate of the case group is 33.3%(43/129). Of the 50 healthy children in the control group, 2 were sera B19 DNA positive and none was IgM positive and the infection rate of the control group was 2%(1/50). The positive rates of B19 DNA and antigen in the bone marrow samples of the 50 patients with hematonosis were 34% (17/50) and 16%(8/50). Compared with nested PCR, the sensitivity, specificity, crude agreement, positive predictive value and negative predictive value of ELISA were 63.4%, 97.7%, 86.8% , 92.8% and 85.1%, respectively, while those of IIF were 47.0%, 100%, 82.0%, 100% and 78.6%, respectively. CONCLUSION: The sensitivity of ELISA and IIF for B19 infection is lower than that of nested PCR. Both B19 DNA and IgM or antigen should be detected in diagnosing B19 infection.

关 键 词：人细小病毒B19 聚合酶链反应 酶联免疫吸附测定 免疫荧光技术 

分 类 号：R373[医药卫生—病原生物学]