摘要
目的分析我院近年儿童麻疹发病特点,探讨早期诊断麻疹的实验室方法。方法对2003年确诊的86例麻疹患儿的发病特点进行分析。留取的咽拭子、新鲜尿标本采用逆转录聚合酶链反应(RT-PCR)方法检测麻疹病毒N基因相关片段,静脉血标本用传统的ELISA方法检测麻疹病毒IgM抗体,并对两种实验室检测结果进行比较。结果外地打工人员子女为主要患病人群,1岁以内婴儿发病率居各年龄段发病率之首,轻型和不典型病例增多,重症和死亡病例减少。在病程早期,麻疹病毒N基因相关片段检测阳性率为87.5%(28/32),MV特异性IgM阳性率为67.9%(19/28),两者无显著性差异。结论近年儿童麻疹发病有其新特点。用RT-PCR方法检测麻疹病毒N基因留取标本方便,无痛苦,在病程早期即可检测到,且单份标本就可进行检测,故在麻疹早期,对不典型麻疹病例检测麻疹病毒N基因较检测MV特异性IgM更有助于明确诊断和鉴别诊断。
Objective To investigate the clinical manifestations of children measles in our hospital in recent years. To discuss the laboratory methods used to diagnosis measles in the early stage. Methods The throat swabs and urine samples of children and infants with clinical diagnosis or suspected measles and viral exanthema were collected from January to December in 2003. Measles N gene fragment was detected by using reverse transeriptase polymerase chain reaction （RT-PCR）. Serum specific IgM antibody against measles virus was also tested by ELISA. At the same time, we reviewed the clinical data of these patients. Results The majorty of patients with measles were children of low income people from area outside of Beijing. The highest morbidity were patients under 1 year of age. Mild and atypical cases were increased, and the cases with severe disease and death were decreased. In early clinical stage, positive rate of MV N gene fragment detected with RT-PCR in the throat swabs and urine samples was 87.5%（28/32）, and the specific IgM antibody tested by ELISA was 67.9%（19/28）. No significant difference was found between them. Conclusions Measles of children and infant eases have new clinical characteristics in recent years. The throat swabs and urine samples used for MV N gene fragment detection by using RT-PCR arc easy to collect and single clinical sample can be tested. So identify gene material at early clinical stage of measles and in atypical measles is useful for clarifying the diagnosis and differential diagnosis.
出处
《北京医学》
CAS
2006年第5期281-283,共3页
Beijing Medical Journal
