实时荧光定量PCR快速检测脑膜炎奈瑟菌的临床价值

doi:10.3969/j.issn.1673-8640.2018.04.015

摘要/Abstract

摘要：

目的探讨实时荧光定量聚合酶链反应（PCR）快速检测流行性脑脊髓膜炎（简称流脑）病原菌脑膜炎奈瑟菌（Nm）的临床价值。方法收集70例疑似流脑病例的双份脑脊液标本,1份采用细菌培养法进行检测,另1份采用实时荧光定量PCR进行检测,比较2种方法的检出阳性率以及敏感性和特异性。结果采用细菌培养法检出Nm阳性49例,阳性率为70.00%;实时荧光定量PCR检出Nm阳性67例,阳性率为95.71%,二者阳性率比较差异有统计学意义（P<0.05）。实时荧光定量PCR检测结果与细菌培养法阳性符合率为70.00%,其中有18例细菌培养法为阴性而实时荧光定量PCR为阳性。实时荧光定量PCR检测Nm的特异性为100%,无假阴性结果,阳性预测值为73.13%,阴性预测值为0.00%,检测下限为10³拷贝/mL,线性范围为2×10³~2×10⁷拷贝/mL。结论实时荧光定量PCR检测Nm敏感性高、特异性强,且快速简便,为流脑流行病学调查提供了一种快速、简便的病原学诊断手段。

关键词: 脑膜炎奈瑟菌, 流行性脑脊髓膜炎, 实时荧光定量聚合酶链反应

Abstract:

Objective To study the role of real-time fluorescence quantitation polymerase chain reaction（PCR） for Neisseria meningitidis（Nm） determination. Methods A total of 70 cerebrospinal fluid specimens were collected from patients with suspected meningitis. One part was performed bacterial culturing,and another part was determined by real-time fluorescence quantitation PCR. The positive rates,sensitivities and specificities of the 2 methods were compared. Results The positive rate of Nm by bacterial culturing was 70.00%（49 cases）. Real-time fluorescence quantitation PCR showed a positive rate of 95.71%（67 cases）. There was statistical significance for the positive rates between the 2 methods（P<0.05）. The results of real-time fluorescence quantitation PCR and bacterial culturing showed a consistency rate of 70.00%. There were 18 cases being negative by bacterial culturing but being positive by real-time fluorescence quantitation PCR. The specificity of real-time fluorescence quantitation PCR was 100%,and no false negative results were obtained. The positive and negative predictive values were 73.13% and 0.00%,respectively. The lower limit of determination was 10³ copies /mL. The linear range was 2×10³-2×10⁷ copies/L. Conclusions Real-time fluorescence quantitation PCR for Nm determination has high sensitivity and specificity and is rapid and convenient,which can be used for the etiological diagnosis of meningitis epidemiology.

Key words: Neisseria meningitidis, Meningococcal meningitis, Real-time fluorescence quantitation polymerase chain reaction

中图分类号:

R446.1

王崇义, 史训忠, 孙正林. 实时荧光定量PCR快速检测脑膜炎奈瑟菌的临床价值[J]. 检验医学, 2018, 33(4): 339-342.

WANG Chongyi, SHI Xunzhong, SUN Zhenglin. Real-time fluorescence quantitation polymerase chain reaction for Neisseria meningitidis determination[J]. Laboratory Medicine, 2018, 33(4): 339-342.

图/表 3

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