IgM抗体检测对EV71感染手足口病诊断价值的探讨

发布时间：2018-02-10 21:01

本文关键词： 手足口病 EV IgM抗体荧光定量RT-PCR　出处：《现代预防医学》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨检测血清EV71-IgM抗体在EV71感染手足口病早期诊断中的应用价值。方法综合收集广西地区2014年4月-10月和2016年4月-10月临床诊断手足口病患儿436例,对所有患儿血清进行EV71-IgM抗体检测。其中136例患儿同时采集咽拭子或肛拭子通过荧光定量RT-PCR检测EV71-RNA。录入数据后采用SPSS 17.0进行统计学分析。结果临床诊断手足口病436人中EV71-IgM抗体阳性256例,阴性180例,危重症组和重症组的EV71-IgM抗体阳性率高于轻症组,差异有统计学意义(χ2=88.016,P0.001)。以荧光定量RT-PCR检测为标准,同时检测136例患儿肛拭子或咽拭子EV71-RNA和血清EV71-IgM抗体,2种方法的检测一致性中等可靠(Kappa=0.575,P0.001)。EV71-IgM检测的灵敏度为93.67%(74/79),特异度为61.40%(35/57)。EV71-IgM抗体阳性检出率在病程1~3 d逐渐升高,在病程d3检出率达到92.31%,在病程4~10 d检出率达到100.00%。结论血清EV71-IgM抗体检测具有较高的灵敏度,可行性强,操作方便,对早期诊断手足口病病原学有良好的应用价值。
[Abstract]:Objective to investigate the value of detecting serum EV71-IgM antibody in the early diagnosis of HFMD infected with EV71. Methods Clinical diagnosis of HFMD in Guangxi from April 2014 to October and April 2016 to October were collected. EV71-IgM antibody was detected in serum of all children, among them, throat swabs or anal swabs were collected simultaneously by fluorescence quantitative RT-PCR to detect EV71-RNA.After entering the data, SPSS 17.0 was used for statistical analysis. Results Clinical diagnosis of HFMD 436. There were 256 positive cases of EV71-IgM antibody in human. The positive rate of EV71-IgM antibody in critically ill group and severe group was significantly higher than that in mild group (蠂 2 88.016 P 0.001). Fluorescence quantitative RT-PCR was used as the standard. At the same time, the two methods of detecting anal swab or pharyngeal swab EV71-RNA and serum EV71-IgM antibody were consistent and reliable. The sensitivity was 93.6774 / 79 and the specificity was 61.400.35 / 57.EV71-IgM antibody positive rate increased gradually at 1 day after the disease course. The detectable rate of serum EV71-IgM antibody was 92.31 on the day of the disease course and 10 days after the course of the disease. Conclusion the detection of serum EV71-IgM antibody is sensitive, feasible and easy to operate. It has a good application value in the early diagnosis of hand, foot and mouth disease etiology.
【作者单位】：广西医科大学第一附属医院儿科;
【基金】：国家自然科学基金项目(81460251) 广西壮族自治区手足口病防治研究资金(2014249)
【分类号】：R725.1

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