Wassilak S G, Bernier R H, Herrmann K L, Orenstein W A, Bart K J, Amler R
Pediatr Infect Dis. 1984 Mar-Apr;3(2):117-21. doi: 10.1097/00006454-198403000-00007.
Because the incidence of measles has declined in recent years, the potential for confusion of measles with other morbilliform rashes has increased. Routine serologic testing of suspected cases of measles is recommended but it has been hampered, particularly in young infants and children, by the requirement of performing venipuncture. We have compared measles hemagglutination inhibition antibody testing performed on dried capillary whole blood collected on filter paper strips with testing of serum specimens obtained simultaneously by venipuncture. We assessed overall comparability, diagnostic sensitivity and specificity and acceptability and practicality for field use. Of the 125 capillary-venous sets compared, there was a 4-fold difference in hemagglutination inhibition titer between the two types of specimens in only one set (0.8%). Diagnostic sensitivity using capillary blood was 100% and specificity was 96%. Immunoglobulin M assessments on six capillary-venous sets were in complete agreement (three positive in both, three negative in both). In a pilot program of field use, filter paper blood collection was associated with a 97% (36 of 37) success rate in obtaining specimens from individuals with suspected cases of measles. This method of blood collection and testing is an accurate, feasible and acceptable means for seroconfirmation of measles.
由于近年来麻疹发病率有所下降，麻疹与其他斑丘疹混淆的可能性增加。建议对疑似麻疹病例进行常规血清学检测，但由于需要进行静脉穿刺，这一检测受到了阻碍，尤其在幼儿群体中。我们对比了麻疹血细胞凝集抑制抗体检测对滤纸带上采集的干燥毛细血管全血的检测结果与同时通过静脉穿刺获得的血清样本的检测结果。我们评估了总体可比性、诊断敏感性和特异性以及现场使用的可接受性和实用性。在对比的125组毛细血管血-静脉血样本中，只有一组（0.8%）的两种样本间血细胞凝集抑制效价存在4倍差异。使用毛细血管血的诊断敏感性为100%，特异性为96%。对6组毛细血管血-静脉血样本进行的免疫球蛋白M评估结果完全一致（两组均为3例阳性，两组均为3例阴性）。在一项现场使用的试点项目中，从疑似麻疹病例个体采集样本时，滤纸采血成功率为97%（37例中的36例）。这种采血和检测方法是血清学确诊麻疹的一种准确、可行且可接受的手段。
