检验医学 ›› 2023, Vol. 38 ›› Issue (1): 28-31.DOI: 10.3969/j.issn.1673-8640.2023.01.006

• 论著 • 上一篇    下一篇

新型冠状病毒抗原检测诊断效能和临床应用评价

杨丹平, 王宏, 王灿, 陈卫, 杨爱平()   

  1. 上海市松江区九亭医院,上海 201615
  • 收稿日期:2022-02-01 修回日期:2022-10-25 出版日期:2023-01-30 发布日期:2023-03-15
  • 通讯作者: 杨爱平,E-mail:393128549@qq.com
  • 作者简介:杨丹平,女,1982年生,学士,主管技师,主要从事分子生物学检验工作。

Diagnostic efficacy and clinical application evaluation of SARS-CoV-2 antigen determination

YANG Danping, WANG Hong, WANG Can, CHEN Wei, YANG Aiping()   

  1. Shanghai Songjiang Jiuting Hospital,Shanghai 201615,China
  • Received:2022-02-01 Revised:2022-10-25 Online:2023-01-30 Published:2023-03-15

摘要:

目的 探讨新型冠状病毒(SARS-CoV-2)抗原检测的临床应用价值及其诊断效能。方法 随机选取2022年3—6月上海市松江区某方舱无症状SARS-CoV-2感染初期患者340例、某封控小区居民4 294名、某管控小区居民420名、某防范小区居民800名进行SARS-CoV-2抗原检测,采用核酸双试剂复核SARS-CoV-2抗原阳性结果。采用受试者工作特征(ROC)曲线评价SARS-CoV-2抗原检测诊断SARS-CoV-2感染的效能。结果 方舱SARS-CoV-2感染患者进舱第1天抗原检测阳性率为81.0%。封控小区和管控小区居民抗原检测真阳性率平均为43.1%。核酸检测阳性率明显高于抗原检测真阳性率(P<0.01),2种检测方法的一致性较差(Kappa=0.266)。SARS-CoV-2阳性患者抗原转阴时间显著早于核酸转阴时间(P<0.05),且循环阈值(Ct)>28时抗原试剂检测线(T线)不显色。ROC曲线分析结果显示,SARS-CoV-2抗原检测诊断SARS-CoV-2感染的曲线下面积为0.773。结论 SARS-CoV-2抗原检测可用于SARS-CoV-2的筛查,但不能替代核酸检测。

关键词: 新型冠状病毒, 抗原检测, 核酸检测, 诊断效能

Abstract:

Objective To investigate the clinical application value and diagnostic efficacy of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) antigen determination. Methods From March to June 2022,340 asymptomatic patients at the initial stage of corona virus disease 2019(COVID-19) in a shelter in Songjiang District,4 294 residents in a sealed control area,420 residents in a management control area and 800 residents in a prevention area were randomly enrolled for the determination of SARS-CoV-2 antigen. The positive SARS-CoV-2 antigen determination results were rechecked with double-reagent nucleic acid. Receiver operating characteristic(ROC) curve was used to evaluate the efficiency of SARS-CoV-2 antigen qualitative determination for the diagnosis of SARS-CoV-2 infection. Results The positive rate of SARS-CoV-2 antigen determination on the first day of shelter was 81.0%,and the average true positive rate of SARS-CoV-2 antigen determination in sealed control area and management control area was 43.1%. The positive rate of nucleic acid test was higher than that of SARS-CoV-2 antigen determination(P<0.01),and the consistency of the 2 methods was poor(Kappa value was 0.266). The turn-to-negative time of SARS-CoV-2 antigen determination was earlier than that of nucleic acid test(P<0.05),and the antigen determination line (T line) did not show colour when the cycle threshold(Ct) value was >28. The area under curve was 0.773 for SARS-CoV-2 antigen determination. Conclusions Antigen determination can be used as an auxiliary method in the early screening of SARS-CoV-2,but it can not replace nucleic acid test.

Key words: Severe acute respiratory syndrome coronavirus 2, Antigen qualitative determination, Nucleic acid test, Diagnostic efficacy

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