病毒性脑炎病例中不同标本肠道病毒检出率分析

发布时间：2019-07-01 20:54

【摘要】：目的了解不同类型标本在肠道病毒所致病毒性脑炎病例诊断中的作用。方法采集临床诊断为病毒性脑炎病例标本,采用实时荧光RT-PCR法检测肠道病毒核酸,包括EV71、CA16和其他肠道病毒。结果 143例病例中,脑脊液、肛拭子和咽拭子中的肠道病毒阳性率分别为30.8%、88.1%和71.3%。脑脊液标本中检出率明显低于咽拭子或肛拭子,差异有统计学意义(P0.01)。肛拭子中检出率高于咽拭子,差异有统计学意义(P0.01),2种标本检出一致性一般(Kappa=0.420)。有皮疹出现且临床诊断为手足口重症合并脑炎的患者,脑脊液与其他标本组合后检出率均显著提高,差异有统计学意义(P0.01);脑脊液、肛拭子和咽拭子组合后的检出率同单纯肛拭子和咽拭子组合的肠道病毒检出率之间差异无统计学意义(P0.05)。结论肛拭子组合咽拭子可获得病毒性脑炎病例中肠道病毒的最大检出率。
[Abstract]:Objective to investigate the role of different types of specimens in the diagnosis of enterovirus-induced viral meningitis. Methods the specimens of clinically diagnosed viral meningitis were collected and the nucleic acid of enterovirus, including EV71,CA16 and other enterovirus, was detected by real-time fluorescence RT-PCR. Results in 143 cases, the positive rates of enterovirus in cerebrospinal fluid, anal swabs and throat swabs were 30.8%, 88.1% and 71.3%, respectively. The detection rate of cerebrospinal fluid samples was significantly lower than that of pharynx swabs or anal swabs (P 0.01). The detection rate of anal swabs was higher than that of pharyngeal swabs (P 0.01). The detection rate of anus swabs was generally consistent with that of pharynx swabs (Kappa=0.420). In patients with rash and clinically diagnosed as severe hand, foot and mouth complicated with meningitis, the detection rate of cerebrospinal fluid and other specimens was significantly increased (P 0.01), but there was no significant difference between the detection rate of cerebrospinal fluid, anal swabs and throat swabs and the enterovirus detection rate of simple anal swabs and pharyngeal swabs (P 0.05), but there was no significant difference in the detection rates of enterovirus between cerebrospinal fluid, anal swabs and throat swabs (P 0.05). Conclusion the maximum detection rate of enterovirus can be obtained by anal swabs combined with pharyngeal swabs.
【作者单位】：河南省疾病预防控制中心;
【基金】：河南省基础与前沿技术研究计划项目(142300410-077) 河南省医学科技攻关计划省部共建项目(20160-1028)
【分类号】：R512.3;R440

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