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目的分析北京市朝阳区麻疹疑似病例的实验室检测情况,评价目前麻疹防控中病例的诊断方法。方法采用酶联免疫法(ELISA)对北京市朝阳区2015年麻疹疑似病例血清标本进行麻疹和风疹Ig M抗体检测,对检测结果按照不同人群进行统计分析。其中64个病例同时采集了咽拭子进行核酸检测,并且对部分核酸与血清学结果不一致的标本及双份血均为阴性的标本进行了麻疹Ig G和风疹Ig G抗体的检测。结果综合实验室的血清学及病原学结果,253例“疑似麻疹病例”中确诊麻疹病例119例,阳性率47.04%,确诊风疹病例25例,阳性率9.88%。麻疹、风疹病例性别分布差异无统计学意义(P>0.05)。麻疹和风疹发病主要分布在15~39岁年龄段。对于同时检测核酸和抗体的标本,35例麻疹结果不一致,为抗体阴性核酸阳性,7例风疹结果不一致,表现为6例抗体阴性核酸阳性,1例抗体阳性核酸阴性;麻疹和风疹Ig G的结果显示,35例血清麻疹Ig M阴性但麻疹核酸阳性的病例中,Ig G抗体阳性率91.43%,22名采集双份血Ig M均为阴性的病人,麻疹Ig G阳性率81.82%,风疹Ig G阳性率77.27%。结论对于麻疹疑似病例应综合核酸和Ig M及Ig G抗体的检测,及早并准确地确诊病例。
Objective To analyze the laboratory detection of suspected cases of measles in Chaoyang District, Beijing, and to evaluate the diagnosis methods of cases in the prevention and control of measles. Methods Serum samples of suspected measles cases from 2015 to 2003 in Chaoyang District of Beijing were detected by enzyme-linked immunosorbent assay (ELISA) for measles and rubella IgM antibodies. The test results were statistically analyzed according to different populations. In 64 cases, throat swabs were also collected for nucleic acid detection, and measles Ig G and rubella Ig G antibodies were detected in specimens with some inconsistent results of nucleic acid and serology and negative specimens of both blood samples. Results A total of 119 cases of measles were confirmed in 253 cases of suspected measles cases, with a positive rate of 47.04%. Of the 25 cases diagnosed with rubella, the positive rate was 9.88%. There was no significant difference in the gender distribution of measles and rubella (P> 0.05). The incidence of measles and rubella mainly in the 15 to 39 age group. 35 samples of measles were inconsistent, with positive antibody negatives and inconsistent results of the seven rubella samples, showing 6 positive for the antibody negative and 1 negative for the antibody positive, and the result of Ig G for measles and rubella Showed that IgM antibody positive rate was 91.43% in 35 cases of IgM negative but measles nucleic acid positive, and 22 cases of IgM were negative in both blood samples. The positive rate of measles Ig G was 81.82%, and rubella Ig G The positive rate was 77.27%. Conclusion For the suspected cases of measles should be integrated nucleic acid and Ig M and Ig G antibodies detected early and accurately confirmed cases.