四种腹泻病毒抗原联检技术在临床儿童腹泻诊断中的应用价值

目的 评估四种腹泻病毒（轮状病毒、肠道腺病毒、诺如病毒、星状病毒）抗原联检技术在临床儿童腹泻病毒病原学检测中的应用价值.方法 采用荧光免疫法,四种腹泻病毒抗原联检技术（博晖腹泻四病毒联合检测系统）对临床采集的270份婴幼儿腹泻标本进行检测,并用进口的四种腹泻病毒酶免法单检试剂盒同时进行比对实验.结果 酶免法对轮状病毒、诺如病毒、肠道腺病毒及星状病毒的抗原阳性检出率分别为10.37％,14.81％,1.48％和2.96％;荧光免疫法的抗原阳性检出率分别为9.63％,10.37％,4.07％和2.22％.采用配对资料的χ^2检验进行统计分析,两种方法对轮状病毒、诺如病毒及肠道腺病毒的抗原阳性检出率差异有统计学意义（卡方值分别为121.710,4.685和47.592,P值分别为0.000,0.030和0.000,P值均＜0.05）,对星状病毒的抗原阳性检出率差异无统计学意义（卡方值为0.187,P值为0.665,P值＞0.05）;两种方法对轮状病毒的检测结果具有较好的一致性（Kappa值为0.558,0.4＜Kappa值＜0.75）,对诺如病毒、肠道腺病毒和星状病毒的检测结果一致性较差（Kappa值分别为0.142,-0.025和0.361,Kappa值均≤0.4）.结论 两种腹泻病毒检测方法之间除轮状病毒外,其它病毒检测结果的一致性较差,这些方法只可用于腹泻病原的初步筛查,确认必须进一步做培养或分子诊断.但是,在临床检测工效上,荧光免疫法有着明显的优势.

Application Value of Antigen Detection Technology of Four Kinds of Diarrhea Virus in Clinical Diagnosis of Children Diarrhea

Objective To evaluate four kinds of diarrhea virus （RV,EAdV,NV,AstV） antigen joint inspection technology in clinical child diarrhea virus etiology examination on the application of value.Methods Using fluorescence immunoassay method,four kinds of diarrhea virus antigen joint inspection technology （diarrhea four virus joint detection system of Bo Hui） to detect clinical samples of 270 infant with diarrhea and compared experiment with four kinds of import diarrhea virus,enzyme-linked immunoassay single test kit at the same time.Results Elisa method of RV,NV,EAdV,AstV antigen positive detection rate were 10.37 %,14.81 %,1.48% and 2.96 %,respectively.Fluorescence immunoassay antigen positive detection rate were 9.63%,10.37%,4.07% and 2.22%,respectively.χ^2 test for paired data for statistical analysis：two methods of RV,NV,EAdV detection rate was statistically significant （Chi-square values were 121.710,4.685,47.592,P value were 0.000,0.030,0.000,P values 〈0.05）.AstV detection rate without statistical significance （Chi-square values was 0.187,P value was 0.665,P〉0.05）.Two methods for the detection of RV had good consistency （Kappa value was 0.558,0.558〈Kappa values〈0.75）,and of EAV,NV and AstV had poor consistency （Kappa value was 0.142,0.025 and 0.142,respectively,Kappa value of 0.4 or less）.Conclusion Current between the diarrhea virus detection methods except RV,the consistency of other virus detection was poorer.These methods only can be used for preliminary screening diarrhea pathogens,confirmation must further develop or molecular diagnosis.But,in clinical detection efficiency,fluorescence immunoassay method has obvious advantages.