[临床资料及快速检测技术（TestPack A群链球菌检测试剂）在急性链球菌性咽扁桃体炎诊断中的评估]

[Evaluation of clinical data and a technique of rapid detection (TestPack Strep A) in the diagnosis of acute streptococcal pharyngo-tonsillitis].

作者信息

Bladé J, Alaman E, Cartaña A, Guinea I, Liberal A, Herreros M, Masdeu R M, Pallejà J, Tapiol J

机构信息

Centre Docent de Medicina Familiar i Comunitària, Valls, Tarragona.

出版信息

Aten Primaria. 1991 Feb;8(2):92, 94, 96-8.

PMID:1893053

Abstract

We have evaluated the validity of the clinical data, the clinical impression (CI) of the physician and a rapid antigenic technique (RAT) for the diagnosis of acute streptococcal pharyngitis and tonsillitis (SPT). We evaluated 126 patients aged 7-60 years (October 1988-March 1989). The incidence of SPT was 19%. SPTs had a significantly higher frequency of lack of cough and sudden onset as isolated findings, and of the associations fever greater than 38 degrees C + exudate + lack of cough, and sudden onset + fever greater than 38 degrees C + exudate + lack of cough. CI had a sensibility (S) of 56%, a specificity (Sp) of 72%, a positive predictive value (PPV) of 32%, a negative predictive value (NPV) of 88% and an overall valve (OV) of 69%. The RAT had a S of 79.2%, a Sp 93%, a PPV of 73%, a NPV of 95%, and an OV of 90.5%. Only some clinical data are useful to diagnose SPT. The CI of the physician has a low predictive value, whereas TestPack Strep A is useful and has a similar value as pharyngeal culture.

摘要

我们评估了临床数据、医生的临床印象（CI）以及一种快速抗原检测技术（RAT）在诊断急性链球菌性咽炎和扁桃体炎（SPT）方面的有效性。我们对126名年龄在7至60岁之间的患者进行了评估（1988年10月至1989年3月）。SPT的发病率为19%。SPT患者中，缺乏咳嗽和突然起病作为单独症状出现的频率显著更高，以及发热超过38摄氏度+渗出物+缺乏咳嗽，和突然起病+发热超过38摄氏度+渗出物+缺乏咳嗽这些症状组合出现的频率也显著更高。CI的敏感度（S）为56%，特异度（Sp）为72%，阳性预测值（PPV）为32%，阴性预测值（NPV）为88%，总体效度（OV）为69%。RAT的S为79.2%，Sp为93%，PPV为73%，NPV为95%，OV为90.5%。只有一些临床数据对诊断SPT有用。医生的CI预测价值较低，而TestPack A型链球菌检测有用，且与咽拭子培养具有相似的价值。