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五种布鲁菌血清学检测方法对比分析
作者:王淑云 刘熹 荣蓉 赵鸿雁 赵赤鸿 朴东日 赵娜 姜海 田国忠 王桂琴 崔步云

摘要:

目的  分析5种检测人的布鲁菌病的血清学方法的特异性和敏感性。方法  于2013年1—12月,在内蒙古自治区的4个自治旗(察右后旗、科右中旗、林西县和四子王旗)进行调查。调查对象纳入标准:以养殖牛羊和屠宰为职业,伴有发热、乏力、关节痛等布鲁菌病疑似症状,年龄为25~55岁。对疑似患者清晨空腹采集静脉血3~5 ml,共采集236份样品。分别采用平板凝集试验(PAT)、虎红平板凝集试验(RBPT)、标准试管凝集试验(SAT)、ELISA和免疫胶体金法(GICA)等5种血清学检测方法进行布鲁菌抗体测定,以SAT为"金标准",分析RBPT、PAT、ELISA和GICA法的敏感性和特异性。结果  SAT法阳性患者136例(57.6%),PAT法阳性患者150例(63.6%),RBPT法阳性患者159例(67.4%),ELISA法阳性患者143例(60.6%),GICA法阳性患者147例(62.3%),不同检测方法检测布鲁菌抗体阳性率差异无统计学意义(χ2=0.52,P=0.264)。以SAT法为"金标准",PAT、RBPT、ELISA和GICA法的灵敏度分别为97.7%(133/136)、98.5%(134/136)、94.8%(129/136)和94.1%(128/136),特异度分别为70.0%(70/100)、75.0%(75/100)、86.0%(86/100)和81.0%(81/100),符合率分别为86.0% (203/236)、88.5%(209/236)、91.1%(215/236)和88.5% (209/236)。结论  ELISA与GICA法在诊断人布鲁菌病中特异性和敏感性都较高,并且两种方法均快速;现场检测可以采用GICA法,大样本检测适宜用ELISA法。

关键词:ELISA;布鲁杆菌属;敏感性与特异性

Abstract:

Objective  To evaluation the specificity and sensitivity of 5 kinds of serological detection methods about brucellosis.Methods  To investigate in the 4 autonomous banner (Cha You Hou Qi, Right-Wing Central Banner of Kerqin Region, Linxi County and Siziwangqi Banner) of Inner Mongolia autonomous region from January to December, 2013. Accepting criteria: professionals of breeding cattle and sheep, and slaughter,accompanied by Bloom's disease suspected symptoms such as fever, fatigue,arthralgia, ranging in age from 25 to 55 years old. To collect suspected patients venous blood 3-5 ml in the morning, a total of 236 samples were collected. To detect the Brucella antibody by using plate agglutination test (PAT), tiger red plate agglutination test (RBPT), standard test tube agglutination test (SAT), enzyme-linked immunosorbent assay (ELISA) and immune colloidal gold method (GICA), SAT was taken as a golden standard, analyzed the sensitivity and specificity of RBPT and SAT, ELISA and GICA.Results  SAT method of positive patients: 136 cases (57.6%). PAT method positive patients: 150 cases (63.6%). RBPT positive patients: 159 cases (67.4%), and 143 patients with ELISA method: positive (60.6%), 147 patients with positive GICA method (62.3%). The detection rate of Brucella antibody positive was different by different testing methods.There was no significant difference (χ2=0.52,P=0.264). To take the SAT method as the gold standard, PAT, RBPT, ELISA and GICA method of the sensitivity were 97.7% (133/136), 98.5% (134/136), 94.8% (129/136) and 94.1% (128/136), respectively. The specificity was lower,the rate were 70.0% (70/100), 75.0% (75/100), 86.0% (86/100) and 81.0% (81/100), respectively. The total coincidence rate were 86.0% (203/236), 88.5% (209/236), 91.1% (215/236) and 88.5% (209/236), respectively.Conclusion  The specificity and sensitivity of ELISA and GICA method is higher in the diagnosis of disease. The two methods are rapid, GICA method can be used on-site testing, large sample test is suitable for using ELISA.

Key words: ELISA;Brucella;Sensitivity and specificity

发表日期:2016/2

引用本文:

图/表:

  • 10.3760/cma.j.issn.0253-9624.2016.02.014.T001:表1 5种方法检测疑似布鲁菌病患者的抗体阳性率(n=236)

    10.3760/cma.j.issn.0253-9624.2016.02.014.T001:表1 5种方法检测疑似布鲁菌病患者的抗体阳性率(n=236)

  • 10.3760/cma.j.issn.0253-9624.2016.02.014.T002:表2 不同方法检测布鲁菌标本的灵敏度、特异度与符合率(n=236)

    10.3760/cma.j.issn.0253-9624.2016.02.014.T002:表2 不同方法检测布鲁菌标本的灵敏度、特异度与符合率(n=236)

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