新型分子病毒检测方法及其在儿童下呼吸道感染中的临床价值。
New molecular virus detection methods and their clinical value in lower respiratory tract infections in children.
机构信息
Department of Pediatrics, Turku University Hospital, Turku, Finland.
出版信息
Paediatr Respir Rev. 2013 Mar;14(1):38-45. doi: 10.1016/j.prrv.2012.04.002. Epub 2012 May 5.
During the past decade, several new respiratory viruses and their subgroups have been discovered. All these new viruses, as well as previously known respiratory viruses, can be detected by sensitive PCR methods, which have become popular in the diagnostic workup of respiratory viral infections. Currently, respiratory viruses can be detected in up to 95% of children with lower respiratory tract illness. On the other hand, virus detection rates in asymptomatic children are also high (up to 68%), as are coinfection rates in symptomatic children (up to 43%) and justified concerns of causality have been raised. Imposing progress has been made in developing multiplex quantitative PCR assays; here, several primer sets are run within a single PCR mixture. These PCR assays give a better understanding of the dominant viral infection, of viral infections that may be incipient and of any waning infections than does a single-target PCR. Multiplex PCR assays are also gaining popularity due to their cost-effectiveness and short throughput time compared to multiple single-target PCRs. Our understanding of the indications of virus PCRs and our ability to interpret the results from a clinical point of view have improved. This paper reviews the progress in PCR assays and discusses their role in the diagnosis of lower respiratory tract infections in children.
在过去的十年中,已经发现了几种新的呼吸道病毒及其亚群。所有这些新病毒以及以前已知的呼吸道病毒都可以通过敏感的 PCR 方法检测到,这些方法在呼吸道病毒感染的诊断中已经变得非常流行。目前,通过 PCR 方法可以在高达 95%的下呼吸道疾病患儿中检测到呼吸道病毒。另一方面,无症状儿童的病毒检测率也很高(高达 68%),症状性儿童的合并感染率也很高(高达 43%),并且已经提出了关于因果关系的合理关注。在开发多重定量 PCR 检测方面已经取得了进展;在这里,多个引物组在单个 PCR 混合物中运行。与单靶标 PCR 相比,这些 PCR 检测可以更好地了解主要的病毒感染、可能处于初期的病毒感染以及任何正在减弱的感染。与多个单靶标 PCR 相比,多重 PCR 检测由于其成本效益和较短的检测时间,也越来越受欢迎。我们对病毒 PCR 指征的理解以及我们从临床角度解释结果的能力都有所提高。本文综述了 PCR 检测的进展,并讨论了其在儿童下呼吸道感染诊断中的作用。