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目的探讨I型登革病毒感染后病毒核酸及其IgM抗体在患者体内的变化规律,为指导临床快速、准确地诊断登革热提供理论支持。方法回顾性分析2014年7-11月收集的I型登革病毒感染者临床资料和血清标本,应用实时荧光定量RT-PCR和ELISA法分别检测病毒核酸和IgM抗体,分析不同病程两者的变化规律。结果共检出222例阳性患者,其中病毒核酸阳性137例,IgM抗体阳性146例,两者同时阳性61例。病程急性期(发病1~5 d)病毒核酸阳性率为75%~100%,IgM抗体阳性率在发病第1~2天较低,但第3~5天快速升高至50%~70%;进入恢复期(发病6~10 d)病毒核酸阳性率即快速降低,8 d后仅20%左右,但IgM抗体阳性率显著升高达95%~100%。急性期和恢复期病毒核酸与IgM抗体检测结果构成比差异有统计学意义(χ~2=63.41,P<0.05)。结论 I型登革病毒感染者急性期病毒核酸阳性率在75%以上。恢复期IgM抗体阳性率在95%以上。根据病程合理选择检测方法,可提高登革热的诊断效率。
Objective To investigate the variation of viral nucleic acid and its IgM antibody in patients with type I dengue virus infection in order to provide theoretical support for clinical diagnosis of dengue fever quickly and accurately. Methods The clinical data and serological samples of type I dengue virus infection collected from July to November 2014 were retrospectively analyzed. The viral nucleic acid and IgM antibodies were detected by real-time fluorescence quantitative RT-PCR and ELISA respectively, law. Results A total of 222 positive patients were detected, of which 137 were positive for viral nucleic acid and 146 were IgM-positive, both of which were positive in 61 cases. The positive rate of viral nucleic acid was 75% -100% during the acute phase of disease (from 1 to 5 days of onset), the positive rate of IgM antibody was lower from the first day to the second day of onset, but rapidly increased from 50% to 70% The positive rate of virus nucleic acid in the recovery phase (from 6 to 10 days of onset) rapidly decreased, only about 20% after 8 days, but the positive rate of IgM antibody increased significantly from 95% to 100%. The ratio of virus nucleic acid to IgM antibody in acute phase and convalescent phase had statistical significance (χ ~ 2 = 63.41, P <0.05). Conclusion The positive rate of virus nucleic acid in the acute stage of type I dengue virus infection is over 75%. Recovery IgM antibody positive rate of 95% or more. According to the course of a reasonable choice of detection methods can improve the diagnostic efficiency of dengue fever.