荧光免疫层析技术在儿童甲型流感诊断中的临床价值

Clinical value of fluorescence lateral flow immunoassay in diagnosis of influenza A in children

摘要:

目的 评价一种新型荧光免疫层析技术在快速检测甲型流感病毒中的价值。方法 2015年7~8月累计收集378例有流感样症状患儿的鼻咽拭子样本，采用荧光免疫层析法，检测鼻咽拭子样本中是否有甲型流感病毒，同时使用胶体金法进行对比检测，所有样本使用RT-PCR验证上述两种检测方法的正确率。结果 378例患儿中，经RT-PCR法检出81例甲型流感病毒阳性，阳性检出率为21.4%；与RT-PCR法相比，荧光免疫层析法与胶体金法的灵敏度分别为90.1%（73/81）、75.3%（61/81），特异性分别为99.3%（295/297）、98.3%（292/297）。荧光免疫层析法检测为阳性的样本平均Ct值（30.6）大于胶体金法检测为阳性的样本平均Ct值（28.7）。结论 与胶体金法相比，采用荧光免疫层析法检测鼻咽拭子样本中的甲型流感病毒具有更高的检测灵敏度和特异性，与RT-PCR法的一致性更好，能够满足临床上对于准确、早期检测甲型流感病毒的需求。

Abstract:

Objective To evaluate the clinical value of a new type of fluorescence lateral flow immunoassay in rapid detection of influenza A virus. Methods A total of 378 samples of nasopharyngeal secretions were collected from 378 children with influenza-like symptoms to detect the influenza A virus by fluorescence lateral flow immunoassay, colloidal gold immunoassay, and RT-PCR between July 2015 and August 2015. Results Of the 378 samples, 81 (21.4%) were positive for influenza A virus by RT-PCR. Compared with RT-PCR, the sensitivities of fluorescence lateral flow immunoassay and colloidal gold immunoassay were 90.1% (73/81) and 75.3% (61/81), respectively, and the specificities were 99.3% (295/297) and 98.3% (292/297), respectively. The average threshold cycle (Ct) value for the positive samples detected by the fluorescence lateral flow immunoassay (30.6) was higher than that for the positive samples detected by the colloidal gold immunoassay (28.7). Conclusions Compared with colloidal gold immunoassay, fluorescence lateral flow immunoassay has higher sensitivity, specificity, and concordance rate with RT-PCR, suggesting that it can be used for early screening and diagnosis of influenza A.