实时荧光核酸恒温扩增技术在解脲脲原体检测中的临床应用价值

摘要

Objective To evaluate the determination of Ureaplasma urealyticum(UU) by real-time fluorescence isothermal RNA amplification assay(SAT). Methods A total of 200 cases of urethral swabs from sperm donors were collected and determined by SAT for UU RNA,real-time fluorescence quantitation polymerase chain reaction(qRT-PCR) for UU DNA and culturing for UU pathogens. UU-positive sperm donors were treated with antibiotics,then they were determined again for UU by qRT-PCR and SAT. Results The positive rates by culturing,qRT-PCR and SAT for UU were 20.0%(40/200),23.0%(46/200) and 22.5%(45/200), respectively. The Kappa value was >0.75 for the consistency of culturing,qRT-PCR and SAT. After antibiotics were given for UU-positive sperm donors for 15 d,the positive rates of qRT-PCR and SAT were 39.1%(18/46) and 32.6%(15/46),respectively. Although there was no statistical significance,the positive rate of SAT was lower than that of qRT-PCR after treatment. Conclusions Culturing,SAT and qRT-PCR can be used for UU screening. However,UU RNA determination by SAT for patients after being given antibiotics is potential.%目的 初步探讨利用实时荧光核酸恒温扩增技术(SAT)检测解脲脲原体(UU)RNA的临床应用价值.方法 对200例捐精体检者采集尿道拭子,分别采用SAT检测UU RNA和实时荧光定量聚合酶链反应(qRT-PCR)检测UU DNA,并采用培养法检测UU病原体;对UU阳性者进行抗菌药物治疗后,再次采用qRT-PCR和SAT进行病原体检测,并对结果 进行比较分析.结果培养法、qRT-PCR和SAT检测UU的阳性率分别为20.0%(40/200)、23.0%(46/200)和22.5%(45/200);三者间一致性比较显示,Kappa值>0.75.对于首次筛查UU DNA阳性者进行抗菌药物治疗,15 d后qRT-PCR和SAT的阳性率分别为39.1%(18/46)和32.6%(15/46),2种方法阳性率差异尽管不具有统计学意义,但有用药后SAT检测UU的阳性率低于qRT-PCR的趋势.结论 UU培养法、SAT和qRT-PCR均可以用于UU的筛查,但用SAT检测UU RNA在判断治疗是否有效上具有更高的临床应用价值.