直接免疫荧光法同时检测儿童多种呼吸道病毒抗原的临床应用

目的：运用一种高效、快速检测呼吸道病毒抗原的方法,为儿童呼吸道病毒感染的诊断提供帮助,指导合理用药,并了解呼吸道病毒流行情况。方法：采用直接免疫荧光法,利用抗病毒特异性单克隆抗体快速检测497名儿童呼吸道分泌物中的呼吸道合胞病毒（RSV）、流感病毒A型（FA）、流感病毒B型（FB）、副流感病毒1型（PIV1）、副流感病毒2型（PIV2）、副流感病毒3型（PIV3）和腺病毒（ADV）等7种呼吸道常见病毒,并进行统计学分析。结果：在497例呼吸道感染患儿中,检出病毒感染106例,检出率为21.33%。其中,呼吸道合胞病毒感染最多,为63例,占阳性病例的59.43%;腺病毒8例,阳性率为7.55%;副流感病毒3型7例,阳性率为6.61%;流感病毒A型5例,阳性率为4.71%;流感病毒B型2例,阳性率为1.89%;副流感病毒1型2例,阳性率为1.89%;副流感病毒2型1例,阳性率为0.94%;混合型18例,阳性率为16.98%。随着患儿年龄的增长,呼吸道病毒的感染率逐步下降,1岁以内的患儿病毒感染率达23.99%,（1～12）岁患儿病毒感染率为15.23%,差异有显著性（P〈0.05）。儿童呼吸道病毒感染以冬、春两季好发,检出率达27.31%,夏、秋两季检出率为14.16%,差异有显著性（P〈0.05）。结论：直接免疫荧光法同时检测多种呼吸道病毒抗原具有经济、高效、简便、快速、直观、特异等优点,是一种对呼吸道病毒感染早期诊断和指导合理用药行之有效的方法。

Clinical Application of Direct Immuno-Flurorescence Assay for Simultaneous Detection of Multiple Viral Antigens in Pediatric Patients with Viral Respiratory Infection

Objective To report an efficient method for simultaneous detection of multiple viral antigens in elindren with respiratory infection. Methods Nasal secretion smears were examined with direct immuno -fluroroscence assay for multiple viral antigens [respiratory syncytial virus （RSV） , influenza virus A and B, FA and FB, parairfluenza virus 1 - 3 and adenovirus, （ADV） ] in 497 pediatric patients with respiratory infection. Results There were altogether 106 positive cases detected （21.33%）. Among the posi- tive cases, the most common infections agent was RSV （n =63, 59.43% of the viral infections）. Other positive cases included： 8 cases of ADV （7.55%）, 7 cases of PIV-3 （6.61%）, 5 cases Of FA （4.71%）. 2 cases Of FB （1.89%）, 2 eases of PIV- 1 （ 1.89% ） and 1 cases of PIV - 2 （0.94%）. The rest 18 cases were of multiple viral infections （ 16.98% ）. The prevalence of pediatric viral respiratory infection was significantly age - related, with 23.99% of positive eases in infants （ i.e. below 12 months old） and only 15.23% of positive cases between 1 - 12years old. Pediatric viral respiratory infectious were also more common in winter and spring （viral antigen positive rate 74/271,27.31% ）. In summer and winter, the positive rate was only 14.16% （32/226）. Conclusion Detection of viral antigens with direct immuno - flurorescence assay in pediatric patients with respiratory infection was rapid and cheap, with satisfactory sensitivity and specificity, and could be applied efficiently clinically.