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目的评价胶体金和免疫渗滤法在筛查临床甲型流感病毒感染中的诊断效率。方法收集2009.6～2009.10我院发热门诊流感样病例咽拭子标本297例,分别用免疫渗滤法和胶体金法进行快速检测,同时采用实时荧光定量PCR和测序进行验证,以评价两种方法的诊断效率。结果在实时荧光定量PCR法及测序证实为甲型流感166份,其中免疫渗滤法灵敏度为54.82%(91/166),与PCR法符合率为66.67%,Kappa值为0.35;胶体金法灵敏度为4.22%(7/166),符合率为45.79%,Kappa值为0.02;在131份甲型流感病毒阴性的标本中,免疫渗滤法特异性为81.68%(107/131),胶体金法特异性为98.47%(129/131);在实时荧光定量PCR检测为甲型H1N1阳性的99份标本中,免疫渗滤法检出率为67.3%,胶体金检出率为5.1%;在两种方法结果不符合108份标本中,免疫渗滤法阳性而胶体金阴性的标本107份,实时荧光定量PCR法并序列测定显示其中84份为甲型流感病毒阳性,23份为阴性;免疫渗滤法阴性而胶体金阳性的1份标本,甲型流感病毒实时荧光PCR检测为阴性。免疫渗滤法在甲型流感病毒的检出率和与PCR方法的符合率方面明显高于胶体金法(P<0.05)。结论免疫渗滤法在甲型流感病毒筛查中优于胶体金法,显示出良好的临床应用前景。
Objective To evaluate the diagnostic efficiency of colloidal gold and immunofiltration in the screening of clinical influenza A virus infection. Methods A total of 297 cases of influenza-like cases in our outpatient department from 2009.6 to 2009.10 were collected for rapid detection by immunofiltration and colloidal gold respectively. Real-time quantitative PCR and sequencing were used to evaluate the efficacy of the two methods Diagnostic efficiency. The results of real-time PCR and sequencing confirmed that the influenza A virus 166, of which immunological percolation method sensitivity was 54.82% (91/166), and the PCR method was 66.67%, Kappa value of 0.35; colloidal gold sensitivity Was 4.22% (7/166), the coincidence rate was 45.79% and the Kappa value was 0.02. In 131 samples of influenza A virus-negative specimens, the specificity of immunoprecipitation was 81.68% (107/131) The specificity was 98.47% (129/131). In the 99 real-time PCR-positive samples of type A H1N1, the detection rate of immunofiltration was 67.3% and the detection rate of colloidal gold was 5.1% Results of 107 kinds of methods do not meet the 108 specimens, immunofiltration positive and colloidal gold-negative specimens 107, real-time fluorescence quantitative PCR and sequencing showed that 84 were positive for influenza A, 23 were negative; immune seepage Negative filter and colloidal gold-positive specimens, influenza A virus real-time PCR test was negative. Immunofiltration was significantly higher than the colloidal gold method (P <0.05) in the detection rate of influenza A virus and its coincidence rate with PCR method. Conclusion Immunofiltration is superior to colloidal gold in the screening of influenza A virus, which shows a good clinical application prospect.