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目的应用实验室免疫学、病原学方法监测合肥市流行性脑脊髓膜炎(流脑)病例感染状况和菌群分布,比较不同方法监测结果。方法采集流脑疑似病例急性期和恢复期血液、急性期脑脊液,实验室诊断方法包括免疫学血清抗体检测、脑脊液抗原检测,病原学血液脑膜炎奈瑟菌(Nm)培养、脑脊液Nm培养,病原学血清Nm的DNA特异片段检测。结果2005-2008年流脑疑似病例421份,实验室监测病例311份,免疫学血清抗体检测方法病例阳性率最高72.4%,其中C群流脑病例阳性率70.9%;临床诊断病例391份,临床诊断病例率92.9%,实验室诊断病例181份,实验室诊断病例率43.0%。结论合肥市流脑监测病例中流脑感染以C群Nm为主;流脑病例实验室诊断与临床诊断之间存在差距,实验室诊断需要结合多种方法,加强质量管理。
Objective To detect the infection status and flora distribution of epidemic cerebrospinal meningitis (MCI) in Hefei using laboratory immunology and etiology methods and compare the results of different methods. Methods The blood and acute cerebrospinal fluid (CSF) in acute and convalescent stage were collected. The laboratory diagnostic methods included immunological serum antibody test, CSF antigen test, Neisseria meningitidis (Nm) culture, Nm culture of cerebrospinal fluid, Detect serum specific Nm DNA fragments. Results 421 cases of suspected meliosis in the epidemic in 2005-2008 and 311 cases of laboratory surveillance were detected. The highest positive rate was 72.4% in immunological serum antibody test, the positive rate was 70.9% in group C, 391 cases were clinically diagnosed The rate of diagnosis was 92.9%, 181 cases were diagnosed in laboratory and 43.0% were diagnosed in laboratory. Conclusion The prevalence of meningitis in Hefei is mainly in C group Nm. There is a gap between laboratory diagnosis and clinical diagnosis in meningitis cases. Laboratory diagnosis needs to combine various methods to enhance quality control.