摘要
目的探讨冠状病毒病(corona virus disease 2019,COVID-19)患者不同部位核酸检测阳性率及其影响因素。方法应用2019-nCoV ORF1ab/N基因双重实时荧光PCR技术对新疆维吾尔自治区第六人民医院2020年1月31日-2月19日定点收治住院的46例COVID-19患者不同部位样本进行2019-nCoV核酸检测,分析比较咽拭子、痰液、粪便的病毒核酸检测阳性率。结果46例COVID-19患者共检测咽拭子246人次,痰液18人次,粪便15人次,其核酸检测阳性率咽拭子43.90%(108/246)、痰液33.33%(5/15)、粪便38.89%(7/18),咽拭子检出阳性率高于痰液及粪便,但三者阳性率差异无统计学意义(P>0.05);对疑难危重型患者有针对性的重点同时采集2种不同生物样本进行2019-nCoV核酸检测,发现10例咽拭子/粪便样本检测阳性率80.00%(8/10)/70.00%(7/10),比4例咽拭子/痰液样本75.00%(3/4)/50.00%(2/4)和2例粪便/痰液样本0.0%(0/2)/50.00%(1/2)同时检测效果明显的高,经Fisher精确检验组内比较无统计学意义(P>0.05)。结论重点监测COVID-19患者选择咽拭子或痰液样本就可以及时明确临床诊断、预估病情进展及预后,对已确诊的COVID-19患者同时采集不同部位样本反复监测2019-nCoV RNA其临床诊断意义不大。
Objective To explore the positive rate of nucleic acid detection in different parts of patients with corona virus disease(COVID-19)and its influencing factors.Methods The 2019-nCo V ORF1 ab/N gene double real-time fluorescent PCR technology was used to carry out 2019-nCo V nucleic acid on samples from different parts of 46 COVID-19 patients who were admitted to hospital at the Sixth People’s Hospital of Xinjiang Uygur Autonomous Region from January 31 to February 19,2020,analyzed and compared the positive rates of viral nucleic acid tests in throat swabs,sputum,and feces.Results 46 COVID-19 patients detected 246 pharyngeal swabs,18 sputum and 15 feces.The positive rate of nucleic acid test was 43.90%(108/246)for pharyngeal swabs,sputum 33.33%(5/15)and Feces 38.89%(7/18),the positive rate of pharyngeal swabs was higher than that of sputum and feces,but there was no statistically significant difference in the positive rates of the three(P>0.05).Two different biological samples were collected simultaneously for2019-nCo V nucleic acid detection for the targeted critical patients,and found 10 cases of pharyngeal swabs/feces samples with a positive rate of 80.00%(8/10)/70.00%(7/10),which was higher than 4 cases pharyngeal swabs/sputum samples 75.00%(3/4)/50.00%(2/4)and 2 feces/sputum samples 0.0%(0/2)/50.00%(1/2)at the same time,and the comparison within the group by Fisher’s exact test was not statistically significant(P>0.05).Conclusion Focusing on monitoring COVID-19 patients,choosing throat swabs or sputum samples can promptly confirm the clinical diagnosis,estimate the progress and prognosis of the disease.The clinical diagnosis of 2019-nCo V RNA is of little significance in the repeated monitoring of 2019-nCo V RNA by simultaneously collecting samples from different sites in confirmed COVID-19 patients.
作者
张弛
宋玉霞
李远达
屈晓娟
蔺志强
易嘉敏
王珂
林国跃
ZHANG Chi;SONG Yuxia;LI Yuanda;QU Xiaojuan;LIN Zhiqiang;YI Jiamin;WANG Ke;LIN Guoyue(The Sixth People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830013,China;The First School of Clinical Medicine,Guangzhou University of Traditional Chinese Medicine,Guangzhou 510006,China;Guangdong Tuberculosis Control Center,Shipai Village,Huangpu Avenue,Tianhe District,Guangzhou City,Guangzhou 510000,China)
出处
《新疆医学》
2021年第7期776-779,824,共5页
Xinjiang Medical Journal
基金
新疆医科大学第八附属医院(原新疆维吾尔自治区第六人民医院)院级课题(项目编号:QLY-KY-2020001)
关键词
新型冠状病毒
新型冠状病毒肺炎
实时荧光逆转录聚合酶链反应
核酸
痰液
咽拭子
粪便
novel coronavirus
novel coronavirus pneumonia
real-time fluorescent reverse transcription polymerase chain reaction
nucleic acid
sputum
pharyngeal swab
feces
