不同方法检测急性呼吸道感染患儿咽拭子与鼻拭子标本诊断呼吸道合胞病毒感染评价.docVIP

不同方法检测急性呼吸道感染患儿咽拭子与鼻拭子标本诊断呼吸道合胞病毒感染的评价 　　[摘要]目的 比较不同方法检测急性呼吸道感染患儿咽拭子与鼻拭子标本的检测结果。方法 收集2011年3月～2012年2月本院临床诊断为急性呼吸道感染的315名患儿的咽拭子和鼻拭子标本，采用实时荧光定量qPCR法和传统病毒培养鉴定两种方法同时检测病毒核酸或抗原，比较其结果。结果 病毒培养鉴定方法中的鼻拭子和咽拭子阳性率分别为12.1%、6.7%，鼻拭子阳性率高于咽拭子（P0.01）。qPCR检测中的鼻拭子阳性率分别为17.1%和6.9%，鼻拭子阳性率高于咽拭子（P0.01）。鼻拭子和咽拭子标本分别用两种检测方法进行比较，qPCR的阳性率均高于病毒培养鉴定方法（P0.01）。以咽拭子培养与鉴定呼吸道合胞病毒（RSV）结果为标准，鼻拭子培养与鉴定、鼻拭子qPCR检测、咽拭子qPCR检测的敏感性分别为57%、91%、24%；特异性分别为91%、88%、94%。结论 鼻拭子标本检测RSV的敏感度高于相应的口咽拭子，且qPCR方法检测RSV的敏感度高于传统病毒培养鉴定法。 　　[关键词]呼吸道合胞病毒；实时荧光定量PCR病毒培养与鉴定；鼻咽拭子 　　[中图分类号] R725.6 [文献标识码] A [文章编号] 1674-4721（2016）07（c）-0118-04 　　[Abstract]Objective To compare the detection result of throat swab and nasal swab samples from children with acute respiratory tract infection detected by different methods.Methods A total of 315 children with respiratory infection were recruited from March 2011 to February 2012，both throat swabs and nasal swabs were collected.Viral nucleic acid or antigen was detected by both qPCR and virus culture method，the result was compared.Results With virus culture method，the positive rate of nasal swabs was 12.1%，which was higher than 6.7% of throat swabs （P0.01）.However，with qPCR，the positive rate of nasal swab was 17.1%，which was higher than 6.9% of throat swabs （P0.01）.Moreover，for the nasal swabs and throat swabs，the positive rate of qPCR was higher than that of virus culture （P0.01）.Base on the outcome of respiratory syncytial virus （RSV） detected with virus culture in throat swabs，the sensitivities and specificities of nasal swabs by virus culture，nasal swabs by qPCR and throat swabs by qPCR was 57%，91%，4% and 91%，88%，94，respectively.Conclusion The detection of RSV with nasal swabs is more sensitive than throat swabs，and qPCR is more sensitive than virus culture. 　　[Key words]Respiratory syncytial virus；qPCR；Virus culture；Throat and nasal swab 　　呼吸道感染是儿童的常见疾病之一。在全球范围内，病毒感染是导致儿童呼吸道感染的主要原因，其中呼吸道合胞病毒（RSV）是引起儿童呼吸道感染的最常见的病毒病原体之一。有研究[1]证实，其是引起婴幼儿下呼吸道感染的最常见病毒。随着分子生物学技术的不断改进，PCR技术被逐渐广泛地应用于临床及科研等领域，该技术