CAJ | 학술논문

目的评价液态芯片法在社区获得性肺炎(CAP)病毒检测中的应用价值.方法采集2013年10月至2014年9月因CAP于首都医科大学附属北京同仁医院和卫生部中日友好医院171例就诊患者的342份鼻咽拭子和口咽拭子,分别采用液态芯片法(xTAG(R) RVP)和普通多重呼吸道病毒核酸检测法(Seeplex RV15)对15种呼吸道病毒进行检测;使用传统方法(间接免疫荧光法和特异性抗原法)对9种呼吸道病原体进行检测;用实时荧光定量-PCR方法进行确认.对检测结果进行统计学分析,并进行临床应用评价.结果 171例CAP患者实时荧光定量-PCR方法的病毒检测阳性率为35.7％ (61/171),其中甲型流感病毒(FluA)、乙型流感病毒(FluB)、呼吸道合胞病毒(RSV)、鼻病毒(HRV)、人偏肺病毒(hMPV)占所有检出病毒的90.5％,平均年龄为49.17岁.实时荧光定量-PCR方法对口咽拭子和鼻咽拭子呼吸道病毒检测的阳性率分别为31.6％和33.9％,两种标本类型差异无统计学意义(Kappa=0.714,P＜0.001;McNemar x2=0,P=1.000).xTAG(R) RVP和Seeplex RV15两种多重呼吸道病毒核酸检测技术对342份标本病毒检测阳性率分别为32.5％与29.5％,两种方法的结果一致率为85.4％(292/342)(Kappa=0.66).传统方法阳性率是14.0％.与Seeplex RV15及传统方法相比,xTAG(R) RVP具有更高的敏感度(93.3％)、符合率(92.4％)和阴性预测值(96.9％),与实时荧光定量-PCR一致率高(Kappa=0.83).结论液态芯片法优于传统方法和普通多重呼吸道病毒核酸检测法,可作为CAP病毒检测的常规方法.
목적 평개액태심편법재사구획득성폐염(CAP)병독검측중적응용개치.방법 채집2013년10월지2014년9월인CAP우수도의과대학부속북경동인의원화위생부중일우호의원171례취진환자적342빈비인식자화구인식자,분별채용액태심편법(xTAG(R) RVP)화보통다중호흡도병독핵산검측법(Seeplex RV15)대15충호흡도병독진행검측;사용전통방법(간접면역형광법화특이성항원법)대9충호흡도병원체진행검측;용실시형광정량-PCR방법진행학인.대검측결과진행통계학분석,병진행림상응용평개.결과 171례CAP환자실시형광정량-PCR방법적병독검측양성솔위35.7％ (61/171),기중갑형류감병독(FluA)、을형류감병독(FluB)、호흡도합포병독(RSV)、비병독(HRV)、인편폐병독(hMPV)점소유검출병독적90.5％,평균년령위49.17세.실시형광정량-PCR방법대구인식자화비인식자호흡도병독검측적양성솔분별위31.6％화33.9％,량충표본류형차이무통계학의의(Kappa=0.714,P＜0.001;McNemar x2=0,P=1.000).xTAG(R) RVP화Seeplex RV15량충다중호흡도병독핵산검측기술대342빈표본병독검측양성솔분별위32.5％여29.5％,량충방법적결과일치솔위85.4％(292/342)(Kappa=0.66).전통방법양성솔시14.0％.여Seeplex RV15급전통방법상비,xTAG(R) RVP구유경고적민감도(93.3％)、부합솔(92.4％)화음성예측치(96.9％),여실시형광정량-PCR일치솔고(Kappa=0.83).결론 액태심편법우우전통방법화보통다중호흡도병독핵산검측법,가작위CAP병독검측적상규방법.
Objective To evaluate the clinical value of viral detection of liquid chip method in community-acquired pneumonia (CAP).Methods A total of 342 swabs were collected from 171 patients of community-acquired pneumonia from October 2013 to September 2014.The methods of xTAG(R) RVP and Seeplex RV15 ACE were employed to detect respiratory viruses.And traditional methods of indirect immunofluorescence and specific antigen were used for comparison.All results were validated by realtimePCR and statistically analyzed.Results Of 171 CAP patients with an average age of 49.17 years,35.7％ (61/171) were virus positive.Influenza A (FluA),influenza B (FluB),respiratory syncytial virus (RSV),human rhinovirus (HRV) and human metapneumovirus (hMPV) accounted for 90.5％ of all detected viruses.The detection rates of mouth swabs and nasopharyngeal swabs were 31.6％ and 33.9％ respectively.Two specimen types showed no significant differences (Kappa =0.714,P ＜ 0.001 ; McNemar x2 =0,P =1.000).The positive rates of viral detection by xTAG(R) RVP and Seeplex RV15 were 32.5％ and 29.5％ respectively.And the consistence rate of results was up to 85.4％ (292/342) (Kappa =0.66).The positive rate of traditional methods was 14.0％.However,xTAG(R) RVP had a higher sensitivity (93.3％),higher consistence rate (92.4％) and negative predictive value (96.9％) compared with Seeplex RV15 and traditional methods.Also xTAG(R) RVP had a high consistent rate of realtime-PCR (Kappa =0.83).Conclusions Liquid chip is superior to other detection methods.And it may be used routinely for viral detection of CAP.