鼻咽拭子与口咽拭子呼吸道病毒抗原检出率比较

doi:10.3969/j.issn.1673-8640.2021.07.008

检验医学 ›› 2021, Vol. 36 ›› Issue (7): 719-721.DOI: 10.3969/j.issn.1673-8640.2021.07.008

鼻咽拭子与口咽拭子呼吸道病毒抗原检出率比较

单佳妮, 汪天林(), 赵水爱, 范礼云, 刘蕾

国家儿童健康与疾病临床医学研究中心国家儿童区域医疗中心浙江大学医学院附属儿童医院,浙江杭州 310052

收稿日期:2020-04-10 出版日期:2021-07-30 发布日期:2021-07-26
通讯作者: 汪天林
作者简介:汪天林,E-mail： Wangtianlin@zju.edu.cn
单佳妮,女,1985年生,学士,主管护师,主要从事儿科护理工作。

Comparison on the determination rates of respiratory virus antigens between nasopharyngeal swabs and oropharyngeal swabs

SHAN Jiani, WANG Tianlin(), ZHAO Shuiai, FAN Liyun, LIU Lei

National Clinical Research Center for Child Health,National Children's Regional Medical Center,Children's Hospital of Zhejiang University School of Medicine,Hangzhou 310052,Zhejiang,China

Received:2020-04-10 Online:2021-07-30 Published:2021-07-26
Contact: WANG Tianlin

摘要/Abstract

摘要：

目的比较鼻咽拭子与口咽拭子常见呼吸道病毒抗原阳性检出率,为临床选择样本类型提供参考。方法选取199例上呼吸道感染患儿,同时采集其口咽拭子和鼻咽拭子样本,按随机原则确定不同患儿采集2个部位样本的先后顺序。2份样本同时送检,采用胶体金免疫分析法检测流行性感冒病毒（Flu）A、 FluB、呼吸道合胞病毒（RSV）和腺病毒（ADV）抗原。结果 199例上呼吸道感染患儿中,鼻咽拭子FluA、FluB、RSV、ADV阳性率和4种病毒的总阳性率分别为31.2%、10.6%、6.0%、5.5%和52.3%,口咽拭子分别为20.6%、7.0%、5.0%、5.0%和37.6%;鼻咽拭子FluA、FluB阳性率和4种病毒总阳性率高于口咽拭子（P<0.05）,RSV、ADV 2种样本阳性率差异无统计学意义（P>0.05）。有40例患儿鼻咽拭子阳性、口咽拭子阴性;有11例患儿鼻咽拭子阴性、口咽拭子阳性;以鼻咽拭子检测结果为标准,口咽拭子FluA、FluB、RSV、ADV的检测敏感性分别为59.7%、61.9%、75.0%和45.5%,特异性均>97%。结论结合操作的便利性,对于儿童患者而言,取单个咽拭子样本检测呼吸道病毒时可仅采集鼻咽拭子样本。对于临床高度疑似病例,可同时采集鼻咽拭子和口咽拭子样本,以提高检出率。

关键词: 呼吸道病毒, 抗原, 鼻咽拭子, 口咽拭子, 儿童

Abstract:

Objective To compare the positive determination rates of common respiratory virus antigens in nasopharyngeal swabs and oropharyngeal swabs,and to provide a reference for clinical selection of sample types.Methods The oropharyngeal swab samples and nasopharyngeal swab samples were collected from 199 children with upper respiratory tract infection. According to random principle,the sequence of samples collected from different patients was determined,and 2 samples were submitted for determination at the same time. Influenza virus（Flu）A,FluB,respiratory syncytial virus（RSV） and adenovirus（ADV） antigens were determined by colloidal gold immunoassay. Results Of the 199 children with upper respiratory tract infection,the total positive rates of FluA,FluB,RSV and ADV were 31.2%,10.6%,6.0%,5.5% and 52.3% for nasopharyngeal swabs and 20.6%,7.0%,5.0%,5.0% and 37.6% for oropharyngeal swabs,respectively. The positive rates of FluA,FluB and 4 viruses were higher in nasopharyngeal swabs than those in oropharyngeal swabs（P<0.05）,while the positive rates of RSV and ADV between the 2 kinds of samples showed no statistical significance（P>0.05）. Nasopharyngeal swabs were positive,and oropharyngeal swabs were negative in 40 children. Nasopharyngeal swabs were negative,and oropharyngeal swabs were positive in 11 children. Nasopharyngeal swab results were used as standard,the sensitivities of oropharyngeal swabs to FluA,FluB,RSV and ADV were 59.7%,61.9%,75.0% and 45.5%,respectively,and the specificities were >97%.Conclusions Combined with the convenience of operation,nasopharyngeal swabs should be selected for respiratory virus determination in children when taking a single pharyngeal swab sample. Since nasopharyngeal swabs are negative,and oropharyngeal swabs are positive in a few cases,samples from both nasopharyngeal and oropharyngeal swabs may be collected for highly suspected cases in clinical practice in order to improve the positive rate.

Key words: Respiratory virus, Antigen, Nasopharyngeal swab, Oropharyngeal swab, Children

中图分类号:

R373.1

单佳妮, 汪天林, 赵水爱, 范礼云, 刘蕾. 鼻咽拭子与口咽拭子呼吸道病毒抗原检出率比较[J]. 检验医学, 2021, 36(7): 719-721.

SHAN Jiani, WANG Tianlin, ZHAO Shuiai, FAN Liyun, LIU Lei. Comparison on the determination rates of respiratory virus antigens between nasopharyngeal swabs and oropharyngeal swabs[J]. Laboratory Medicine, 2021, 36(7): 719-721.

图/表 2

参考文献 9

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鼻咽拭子与口咽拭子呼吸道病毒抗原检出率比较

Comparison on the determination rates of respiratory virus antigens between nasopharyngeal swabs and oropharyngeal swabs

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Metrics

样本类型	FluA	FluB	ADV	RSV	合计
口咽拭子	20.6	7.0	5.0	5.0	37.6
鼻咽拭子	31.2	10.6	5.5	6.0	52.3
χ²值	13.79	4.00	0.00	0.03	16.49
P值	<0.01	<0.05	1.00	0.62	<0.01

口咽拭子	鼻咽拭子
	FluA		FluB		ADV		RSV		合计
	阳性	阴性	阳性	阴性	阳性	阴性	阳性	阴性	阳性	阴性
阳性	37	4	13	1	5	5	9	1	64	11
阴性	25	133	8	177	6	183	3	186	40	84
合计	62	137	21	178	11	188	12	187	104	95