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[爱泼斯坦-巴尔病毒感染的实验室诊断]

[Laboratory diagnosis of Epstein-Barr virus infection].

作者信息

Siennicka Joanna, Trzcińska Agnieszka

机构信息

Zakład Wirusologii PZH w Warszawie.

出版信息

Med Dosw Mikrobiol. 2007;59(3):259-66.

Abstract

Laboratory confirmation of EBV infection requires proper methods and schema of investigation adequate to aim of diagnostic procedure. In paper the results of routine diagnostic tests of EBV infection performed in Department of Virology NIH in 2005-2006 years was included and also, evaluation of usefulness of different laboratory methods was done. Based on results of ELISA tests 10,7% routine investigated subjects was classified as primary EBV infection, 20,1% was seronegative, 7,4% was classified as reactivation of latent infection and serological markers in 45,6% subjects pointed past EBV infection. Positive result of PCR method was obtain in 11,2% samples subjected of routine laboratory investigation. Comparison of specific and non-specific serological methods results (ELISA versus tests of heterophile antibodies) showed the high percentage of false negative results in children tested by non-specific tests. PCR results in serum samples from patients with primary infection (confirmed by serological tests) were positive in 15% cases only. Based on analyzed results it could be stated that reliable confirmation of infectious mononucleosis, as primary EBV infection, is detection of specific IgM antibodies and in case of heterophile antibodies tests the possibility of false negative results, mainly in children, must be taken into account. The most proper samples for PCR method are whole blood, sections of tissue or cells from swabs.

摘要

EBV感染的实验室确诊需要适当的方法和与诊断程序目的相适应的调查方案。本文纳入了2005 - 2006年国立卫生研究院病毒学系进行的EBV感染常规诊断测试结果,并且还对不同实验室方法的实用性进行了评估。基于ELISA测试结果,10.7%的常规调查对象被归类为原发性EBV感染,20.1%为血清阴性,7.4%被归类为潜伏感染的激活,45.6%的对象血清学标志物表明既往有EBV感染。在接受常规实验室检查的样本中,11.2%的样本PCR方法结果呈阳性。特异性和非特异性血清学方法结果的比较(ELISA与嗜异性抗体检测)显示,在接受非特异性检测的儿童中,假阴性结果的比例很高。原发性感染患者(经血清学检测确诊)血清样本的PCR结果仅在15%的病例中呈阳性。基于分析结果可以指出,作为原发性EBV感染的传染性单核细胞增多症的可靠确诊是检测特异性IgM抗体,并且在进行嗜异性抗体检测时,必须考虑到出现假阴性结果的可能性,主要是在儿童中。PCR方法最适合的样本是全血、组织切片或拭子中的细胞。

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