基孔肯雅热实验室检测进展

doi:10.3969/j.issn.1673-8640.2026.10.015

摘要/Abstract

摘要：

基孔肯雅热（CHIKF）是一种由基孔肯雅病毒（CHIKV）引起的经蚊媒传播的急性传染病，主要表现为突发高热、皮疹及严重关节疼痛，关节疼痛可持续数周至数年，严重影响患者生活质量。近年来发病率增高，已成为全球性公共卫生问题。目前，临床上已应用多种实验室检测方法（血清学检测和分子检测），这些方法在感染不同阶段具有不同的检测效能。本文对CHIKF实验室诊断检测技术的研究进展进行系统综述，梳理分子学检测、血清学检测和新兴检测技术，并对各类检测方法的原理、临床应用优势和技术局限性予以评述，旨在为临床及时有效的诊疗提供参考。

关键词: 基孔肯雅热, 基孔肯雅病毒, 血清学诊断, 分子学诊断

Abstract:

Chikungunya fever（CHIKF）is an acute mosquito-borne infectious disease caused by the Chikungunya virus（CHIKV）. It is mainly characterized by sudden high fever，skin rashes and severe arthralgia lasting for weeks to years that seriously impairs patients' quality of life. In recent years，its incidence has risen，becoming a global public health concern. Clinically，multiple laboratory determination methods are available，primarily including serological determination and molecular determination. These methods demonstrate distinct determination efficacy at different stages of infection. This review systematically summarizes the research progress of laboratory determination technologies for CHIKF，encompassing molecular determination，serological determination and emerging determination technologies. It also reviews the principles，advantages in clinical application and technical limitations of various determination methods，aiming to provide timely and effective diagnosis and treatment for patients.

Key words: Chikungunya fever, Chikungunya virus, Serological diagnosis, Molecular diagnosis

中图分类号:

R446.11

徐鹏, 金泰佑, 朴利罗, 胡晓平, 沈梦圆, 孙学鹏, 谭飞. 基孔肯雅热实验室检测进展[J]. 检验医学, 2026, 41(10): 1030-1035.

XU Peng, KIM Tae-woo, PARK Li-ra, HU Xiaoping, SHEN Mengyuan, SUN Xuepeng, TAN Fei. Advances in the laboratory determination of Chikungunya fever[J]. Laboratory Medicine, 2026, 41(10): 1030-1035.

图/表 1

参考文献 32

[1]	Bettis A A, L'Azou Jackson M, Yoon I K, et al. The global epidemiology of chikungunya from 1999 to 2020:a systematic literature review to inform the development and introduction of vaccines[J]. PLoS Negl Trop Dis, 2022, 16(1):e0010069. DOI URL
[2]	Kang H, Auzenbergs M, Clapham H, et al. Chikungunya seroprevalence,force of infection,and prevalence of chronic disability after infection in endemic and epidemic settings:a systematic review,meta-analysis,and modelling study[J]. Lancet Infect Dis, 2024, 24(5):488-503. DOI URL
[3]	Feng Y, Chang F, Yang Y, et al. From dengue to chikungunya:Guangdong as a sentinel for arboviral threats in East Asia[J]. Biosci Trends, 2025, 19(4):368-373.
[4]	JAVAID A, IJAZ A, ASHFAQ U A, et al. An Overview of Chikungunya Virus Molecular biology,epidemiology,pathogenesis,Treatment and Prevention Strategies[J]. Future Virology, 2022, 17(8):593-606. DOI URL
[5]	YEASMIN M, YUSUF M A, RAHMAN M. Diagnostic Limitation of Chikungunya Fever and its Future Prospect:A Review Update[J]. Bangladesh Journal of Infectious Diseases, 2018, 5(2):65-70.
[6]	Li X, Wan X, Liu J, et al. Luciferase immunosorbent assay based on multiple E antigens for the detection of chikungunya virus-specific IgG antibodies[J]. Microbiol Spectr, 2022, 10(2):e0149621. DOI URL
[7]	Islamuddin M, Ali A, Khan W H, et al. Development of highly sensitive sandwich ELISA for the early-phase diagnosis of chikungunya virus utilizing rE2-E1 protein[J]. Infect Drug Resist, 2022:4065-4078.
[8]	Okabayashi T, Sasaki T, Masrinoul P, et al. Detection of chikungunya virus antigen by a novel rapid immunochromatographic test[J]. J Clin Microbiol, 2015, 53(2):382-388. DOI PMID
[9]	Theillet G, Grard G, Galla M, et al. Detection of chikungunya virus‐specific IgM on laser‐cut paper‐based device using pseudo‐particles as capture antigen[J]. J Med Virol, 2019, 91(6):899-910. DOI PMID
[10]	Flórez-álvarez L, Cardona-arias J A. Metanálisis sobre la utilidad de ELISA,PCR e inmunocromatografía en el diagnóstico de chikungunya[J]. Rev Panam Salud Publica, 2017, 41:e163.
[11]	Thirion L, Pezzi L, Corcostegui I, et al. Development and evaluation of a duo chikungunya virus real-time RT-PCR assay targeting two regions within the genome[J]. Viruses, 2019, 11(8):755. DOI URL
[12]	Pongsiri P, Praianantathavorn K, Theamboonlers A, et al. Multiplex real-time RT-PCR for detecting chikungunya virus and dengue virus[J]. Asian Pac J Trop Med, 2012, 5(5):342-346. DOI PMID
[13]	Sinha S, Gahtori R, Kumari P, et al. A novel multiplex RT-PCR for simultaneous detection of malaria,chikungunya and dengue infection(MCD-RT-PCR)[J]. Proc Nat Acad Sci, 2023, 93(3):755-761.
[14]	Sajith A, Iyengar V, Varamballi P, et al. Diagnostic utility of real-time RT-PCR for chikungunya virus detection in the acute phase of infection:a retrospective study[J]. Ann Med, 2025, 57(1):2523559. DOI URL
[15]	Castellanos J E, Jaimes N, Coronel-ruiza C, et al. Dengue-chikungunya coinfection outbreak in children from Cali,Colombia in 2018-2019[J]. Int J Infect Dis, 2021, 102:97-102. DOI PMID
[16]	Reddy V, Ravi V, Desai A, et al. Utility of IgM ELISA,TaqMan real‐time PCR,reverse transcription PCR,and RT‐LAMP assay for the diagnosis of Chikungunya fever[J]. J Med Virol, 2012, 84(11):1771-1778. DOI URL
[17]	Bhardwaj P, Gulafshan S, Singh R. A rapid,specific and ultrasensitive detection of the Chikungunya virus based on RT-RPA:CRISPR/Cas12a one-pot dual mode end-point detection system[J]. Anal Chim Acta, 2024, 1329:343221. DOI URL
[18]	Wei H, Li J, Liu Y, et al. Rapid and ultrasensitive detection of Plasmodium spp. parasites via the RPA-CRISPR/Cas12a platform[J]. ACS Infect Dis, 2023, 9(8):1534-1545. DOI URL
[19]	Qin X, Paul R, Zhou Y, et al. Multiplex solid-phase RPA coupled CRISPR-based visual detection of SARS-CoV-2[J]. Biosens Bioelectron X, 2023, 14:100381.
[20]	Parida M M, Santhosh S R, Dash P K, et al. Rapid and real-time detection of chikungunya virus by reverse transcription loop-mediated isothermal amplification assay[J]. J Clin Microbiol, 2007, 45(2):351-357. DOI PMID
[21]	Luan J, Song S, Cheng C, et al. Development of a capillary-modified naked-eye visual loopmediated isothermal amplification method for the rapid detection of mpox virus and chikungunya virus[J]. Front Microbiol, 2025, 16:1615132. DOI URL
[22]	Wang J, Cheng S, Yi L, et al. Detection of mink enteritis virus by loop-mediated isothermal amplification(LAMP)[J]. J Virol Methods, 2013, 187(2):401-405. DOI URL
[23]	Guevara-vega M, Rosa R B, Caixeta D C, et al. Salivary detection of Chikungunya virus infection using a portable and sustainable biophotonic platform coupled with artificial intelligence algorithms[J]. Sci Rep, 2024, 14(1):21546. DOI PMID
[24]	Ferreira I C C, Aguiar E M G, Silva A T F, et al. Attenuated total reflection-fourier transform infrared(ATR-FTIR)spectroscopy analysis of saliva for breast cancer diagnosis[J]. J Oncol, 2020, 2020:4343590.
[25]	Srivastava N, Verma S, Singh A, et al. Advances in artificial intelligence-based technologies for increasing the quality of medical products[J]. Daru, 2024, 33(1):1. DOI PMID
[26]	Ansari G, Oweis R, Baldaniya L, et al. Early detection of chikungunya virus using silver and zinc selenide multilayer structure utilizing the surface plasmon resonance:a numerical approach[J]. Plasmonics, 2025, 2:9267-9278.
[27]	Wan Ahamad W M A, Kamarun D, Abd Rahman M K, et al. Modular surface plasmon resonance(SPR)biosensor based on wavelength modulation[J]. Adv Theory Simul, 2015, 1107:699-705.
[28]	Yupapin P, Trabelsi Y, Vigneswaran D, et al. Ultra-high-sensitive sensor based on surface plasmon resonance structure having si and graphene layers for the detection of chikungunya virus[J]. Plasmonics, 2022, 17(3):1315-1321. DOI
[29]	Basso C R, Filho M V B, Gavioli V D, et al. Recent advances in nanomaterials for enhanced colorimetric detection of viruses and bacteria[J]. Chemosensors, 2025, 13(3):112. DOI URL
[30]	Singhal C, Khanuja M, Chaudhary N, et al. Detection of chikungunya virus DNA using two-dimensional MoS2 nanosheets based disposable biosensor[J]. Sci Rep, 2018, 8(1):7734. DOI
[31]	World Health Organization Regional Office for South-East Asia. Guidelines on clinical management of Chikungunya fever[M]. New Delhi: WHO Regional Office for South-East Asia, 2019.
[32]	Pan American Health Organization. Recommendations for laboratory detection and diagnosis of arbovirus infections in the region of the Americas[M]. Washington DC: PAHO, 2023.

项目	核心优势	主要局限性
血清学检测
ELISA	可定量分析；包被抗原类型多样，适配IgM/IgG检测；部分抗原抗交叉反应能力强	依赖包被抗原特异性；E2蛋白变异致灵敏度下降30%~40%；天然灭活抗原成本高、生物安全要求高
IC	15 min内快速出结果；便携、成本低，无需专业设备；适配感染早期抗原检测	低病毒载量灵敏度低；恢复期易假阴性；试剂性能差异大，无全球统一质量控制标准
分子学检测
RT-PCR	急性期灵敏度/特异性高，为诊断“金标准”；可检测低载量病毒；多重法可鉴别虫媒病毒共感染	需专业设备/人员，检测成本高；病毒血症期后检测率降低；引物位点突变易致假阴性
CRISPR/Cas12a+RT-RPA	检测限低至1拷贝·个^-1，特异性100.0%；恒温扩增，无需热循环设备；适合现场检测	暂未实现规模化临床应用
毛细管改良 RT-LAMP	无需提取RNA，20~30 min出结果；高通量、低污染；可检测多类型样本	暂未发现显著局限性
新兴检测技术
ATR-FTIR+人工智能	唾液无创采样，无痛、便捷；无需试剂，经济可持续；人工智能提升数据解读效率	原始数据依赖人工智能解析；目前仅有动物实验数据，未达临床极致水平
SPR传感器	超高灵敏度，可定量检测；适配早期微量病毒检测	多为实验室/数值模拟研究，未在临床应用；材料结构优化成本高
纳米材料增强比色检测（MoS₂NSs+SPGEs）	纳米材料提升生物相容性；电极一次性使用，便携；检测线性范围宽	暂未发现显著局限性

项目	核心优势	主要局限性
血清学检测
ELISA	可定量分析；包被抗原类型多样，适配IgM/IgG检测；部分抗原抗交叉反应能力强	依赖包被抗原特异性；E2蛋白变异致灵敏度下降30%~40%；天然灭活抗原成本高、生物安全要求高
IC	15 min内快速出结果；便携、成本低，无需专业设备；适配感染早期抗原检测	低病毒载量灵敏度低；恢复期易假阴性；试剂性能差异大，无全球统一质量控制标准
分子学检测
RT-PCR	急性期灵敏度/特异性高，为诊断“金标准”；可检测低载量病毒；多重法可鉴别虫媒病毒共感染	需专业设备/人员，检测成本高；病毒血症期后检测率降低；引物位点突变易致假阴性
CRISPR/Cas12a+RT-RPA	检测限低至1拷贝·个^-1，特异性100.0%；恒温扩增，无需热循环设备；适合现场检测	暂未实现规模化临床应用
毛细管改良 RT-LAMP	无需提取RNA，20~30 min出结果；高通量、低污染；可检测多类型样本	暂未发现显著局限性
新兴检测技术
ATR-FTIR+人工智能	唾液无创采样，无痛、便捷；无需试剂，经济可持续；人工智能提升数据解读效率	原始数据依赖人工智能解析；目前仅有动物实验数据，未达临床极致水平
SPR传感器	超高灵敏度，可定量检测；适配早期微量病毒检测	多为实验室/数值模拟研究，未在临床应用；材料结构优化成本高
纳米材料增强比色检测（MoS₂NSs+SPGEs）	纳米材料提升生物相容性；电极一次性使用，便携；检测线性范围宽	暂未发现显著局限性