摘要
目的比较不同标本用于麻疹诊断的价值和掌握辖区麻疹病毒基因分型特点,为消除麻疹提供实验室依据。方法采集麻疹疑似病例血液标本210份和咽拭子标本217份,采用酶联免疫吸附试验（ELISA）、逆转录-聚合酶链反应（RT-PCR）和麻疹病毒基因型鉴定用于麻疹病例实验室诊断,比较3种方法的阳性率。结果 210份血液标本中麻疹IgM抗体阳性率为73.33%,随着采样距出疹时间延长阳性率升高,差异有统计学意义（χ~2=4.300,P〈0.05）;217份咽拭子标本中麻疹病毒核酸检测阳性率为82.03%,随着采样距出疹时间延长阳性率下降,差异有统计学意义（χ~2=14.158,P〈0.01）。对其中144份咽拭子标本同时进行麻疹病毒核酸检测和病毒分离,结果显示麻疹病毒核酸检测阳性率高于病毒分离率,差异有统计学意义（χ~2=70.014,P〈0.05）。检测到的麻疹病毒基因型均为国内流行株H1a型。结论麻疹病毒核酸检测阳性率较高,比较适合于早期（出疹初期）病例的实验室诊断,对早期血清IgM阴性的疑似病例也可用此法复检,可增加疑似病例的麻疹诊断率。
Objective To compare the different samples used for measles diagnosis and to understand the genotypes of measles virus in supervised district,which provides laboratory basis for prevention of measles. Methods210 blood samples and 217 throat swab samples were collected from measles suspected cases. The enzyme-lined immunosorbent assay（ ELISA）,reverse transcriptase polymerase chain reaction（ RT-PCR）,and measles virus genotype identification were used to the laboratory diagnosis and the positive rates calculated from the results of the 3 different methods were compared. Results The positive rate of measles Ig M antibiotics was73. 3% among the 210 blood samples,and the rate increased by the sampling from rash time rise（ χ~2=4. 300,P〈0. 05）. The positive rate of nucleic acid was 82. 0% among the 217 throat swab samples,and the rate decreased by by the sampling from rash time decline（ χ~2= 14. 158,P〈0. 01）. Nucleic acid detection and virus isolation was conducted to 144 samples at the same time. The results showed that the positive rate of measles virus nucleic acid was higher than the virus isolation rate（ χ~2= 70. 014,P〈0. 05）. All the detected genotypes were H1 a,which had high prevalence in China. Conclusions Using the measles virus nucleic acid method had higher positive rate and therefore,it can be used for early diagnosis. It can also be used for the recheck of suspected cases with negative serum Ig M,which can improve the diagnosis effect in suspected cases.
出处
《医学动物防制》
2015年第12期1319-1320,1323,共3页
Journal of Medical Pest Control
基金
2014年深圳市科技研发资金资助项目(JCYJ2014040164811661)
2013年深圳市龙岗区科技计划医疗卫生项目(YS2013185)
