上海市1例输血性三日疟病例的实验室检测分析与诊断

发布时间：2018-03-17 17:32

本文选题：疟疾　切入点：输血　出处：《中国血吸虫病防治杂志》2015年04期 　论文类型：期刊论文

【摘要】：目的对1例感染源不明的三日疟病例进行实验室检测分析并确诊。方法收集该病例的临床资料,并进行流行病学调查。对患者及其供血者的血样进行血涂片病原学检查、疟疾快速诊断检测(RDT)和巢式PCR检测,并对阳性结果进行测序比对。结果该患者无疟疾流行区居留史和既往疟疾感染史,有外科手术时大量输血史。外周血涂片镜检查见三日疟原虫。流行病学调查显示,该患者接受了3位供血者的血液,但3位供血者血样经血涂片镜检、RDT和巢式PCR检测均未查见疟原虫,后经改进的巢式-多重PCR检测及结果测序比对后显示,与其中1名非洲籍留学生供血者的阳性扩增条带具100%同源性。结论该病例因输血而感染三日疟。实验室检测疟疾疑难病例需经多方法验证方可确诊,改进的巢式-多重PCR方法对低密度疟原虫感染有较好的检测效果。
[Abstract]:Objective to analyze and diagnose a malaria case with unknown infection source in 3rd. Methods the clinical data of the case were collected and epidemiological investigation was carried out. The blood samples of the patients and their blood donors were examined by blood smear etiology. The positive results were sequenced and compared. Results the patient had no history of malaria-endemic area and previous history of malaria infection. He had a history of massive blood transfusions during surgery. The peripheral blood smear examination showed that on 3rd, the patient received blood from three donors. However, no plasmodium was detected by microscopic examination of blood smears and nested PCR in 3 blood donors, and the improved nest-multiple PCR detection and sequencing analysis showed that Plasmodium falciparum was not detected. There was 100% homology with the positive amplified bands of one of the blood donors from African students. Conclusion this case was infected with malaria in 3rd because of blood transfusion. The improved nested-multiplex PCR method is effective in the detection of low density Plasmodium infection.
【作者单位】：上海市疾病预防控制中心;中国疾病预防控制中心寄生虫病预防控制所;
【基金】：上海市卫生局科研项目(20134349)
【分类号】：R531.3

【参考文献】