麻疹患儿粪便麻疹病毒核酸的检测及临床意义

摘要

目的：探讨麻疹患儿肠道排毒情况和粪便病毒核酸快速检测的临床意义。方法38例临床诊断麻疹患儿，入院时均有发热、皮疹等麻疹感染症状。在入院2d内同时采集咽拭子和粪便标本。标本在冷链条件下送传染病诊治国家重点实验室，采用RT- PCR法检测麻疹病毒核酸及Ct值。同时对部分咽拭子和粪便标本扩增均阳性的PCR产物进行基因测序。结果38例患儿粪便麻疹病毒核酸阳性37例，占97.4%，Ct值23.8±3.04；咽拭子病毒核酸阳性35例，占92.1%，Ct值28.0±4.0。两者阳性率比较，差异无统计学意义（χ2=0.029，P＞0.05）；两组Ct值比较，差异有统计学意义（t=5.23，P＜0.05）。3例患儿咽拭子和粪便标本的麻疹病毒基因型（均为H1a基因亚型）和核苷酸序列完全一致。结论粪便病毒核酸快速检测与咽拭子标本具有相同的临床诊断价值，粪便病毒核酸拷贝数高于咽拭子病毒核酸，且粪便标本的采集具有方便、无痛苦，依从性好，不易受人为因素的影响，值得推广。%Objective To evaluate the application of stool samples in detection of nucleic acid in children with measles. Methods Thirty eight children with a clinical diagnosis of measles were admitted in Hangzhou Children's Hospital from March to June 2013. The throat swabs and stool specimens were col ected within 2 days of admission. The specimens were examined with fluorescence quantitative RT- PCR for nucleic acid of measles virus. Results The viral nucleic acid was positive in 37 stool specimens (97.4%) with a Ct value of 23.8±3.04 and in 35 throat swabs samples (92.1%) with a Ct value of 28.0±4.0, respec-tively (positive rate:χ2=0.029, P>0.05;Ct value:t=5.23, P<0.05). The amplified PCR products were positive in gene sequencing. Conclusion The stool sample has the same diagnostic value as throat swab specimens in detection of measles viral nucleic acid and the former is more convenient with better compliance for col ection.