摘要
目的 建立新型冠状病毒SARS-CoV-2核酸检测方法,比较新型冠状病毒感染肺炎患者上下呼吸道标本核酸检测结果的差异,为临床诊断 SARS-CoV-2感染,如何选择标本类型以及提高核酸阳性检出率提供参考。方法 采集31例疑似新冠肺炎患者呼吸道标本,采用实时荧光定量RT-PCR方法对新型冠状病毒感染者的咽拭子和痰液标本进行双靶标(ORF1ab基因和N基因)核酸检测,应用卡方检验分析不同类型标本新型冠状病毒核酸阳性率的差异。结果 31份新型冠状病毒病例的咽拭子标本中,26份阳性,5份阴性,阳性率为83.8%;31份痰液标本中,29份阳性,2份阴性,阳性率为93.5%;两种标本检测结果差异无统计学意义(χ2=1.449,P＞0.05)。不同发病时间患者咽拭子阳性率和痰液阳性检出率差异均无统计学意义(P=0.669)。比较咽拭子和痰液ORF1ab基因平均CT值(荧光信号达到设定的阈值时所经历的循环数),咽拭子较痰液高3.04; N基因CT值咽拭子较痰液高3.33。1例患者呼吸道标本阴性,肛拭子新冠病毒核酸阳性。结论 咽拭子和痰液标本,均可用于SARS-CoV-2核酸检测。痰液ORF1ab基因和N基因CT均值低于咽拭子,更易检出,用于检测SARS-CoV-2更具优势。此外,呼吸道标本核酸检测阴性的患者,进一步检测消化道标本,对患者临床判断和疾病防控具有重要意义。
Abstract
Objective To establish SARS-CoV-2 nucleic acid detection method,and compare the difference of nucleic acid detection results between the upper and lower respiratory tract specimens of COVID-19 patients,so as to provide reference for clinical diagnosis of SARS-CoV-2 infection,selection of specimen types and improvement of nucleic acid positive detection rate. Methods The respiratory tract specimens of 31 patients with suspected COVID-19 were collected,and the real-time fluorescence quantitative RT-PCR method was used to detect the double-target (ORF1ab gene and N gene) nucleic acid of pharyngeal swabs and sputum specimens of those patients.The SARS-CoV-2 positive rate of different types of specimens was analyzed by chi square test. Results Of the 31 pharyngeal swab specimens of COVID-19 cases,26 were positive and 5 were negative,with a positive rate of 83.8%.Of the 31 sputum samples,29 were positive and 2 were negative,with a positive rate of 93.5%.There was no statistically significant difference in specimen test results (χ2=1.449,P＞0.05).There was no significant difference in the positive rate of pharyngeal swabs and sputum samples in patients with different onset time (P=0.669).The mean CT value of ORF1ab gene in pharynx swabs and sputum samples were compared (the number of cycles experienced when the fluorescence signal reached the set threshold).The mean CT value in pharynx swabs was 3.04 higher than that in sputum samples.The value of CT in N gene was 3.33 higher than that in sputum samples.One patient was negative in respiratory tract and positive in anal swab. Conclusion Pharyngeal swabs and sputum samples could be used for the detection of SARS-CoV-2 nucleic acid.The mean CT value of ORF1ab gene and N gene in sputum samples were lower than that in pharynx swabs,which was easier to detect,and was more advantageous for detecting SARS-CoV-2.In addition,for patients with negative nucleic acid test of respiratory tract specimens,further testing of gastrointestinal specimens was of great significance to patients' clinical judgment and disease prevention and control.
关键词
新型冠状病毒 /
实时荧光定量RT-PCR /
CT值 /
新发传染病
Key words
SARS-CoV-2 /
Real-time fluorescence quantitative RT-PCR /
CT value /
New infectious disease
王小波, 余寿杰, 曾凡荣, 刘江, 杨光, 何玢, 张洁, 朱利杰, 孙梦阳.
淮南市新型冠状病毒核酸检测结果分析[J]. 安徽预防医学杂志. 2020, 26(2): 89-91 https://doi.org/10.19837/j.cnki.ahyf.2020.02.002
WANG Xiaobo, YU Shoujie, ZENG Fanrong, LIU Jiang, YANG Guang, HE Bin, ZHANG Jie, ZHU Lijie, SUN Mengyang.
Analysis of SARS-CoV-2 nucleic acid detection results in Huainan City[J]. Anhui Journal of Preventive Medicine. 2020, 26(2): 89-91 https://doi.org/10.19837/j.cnki.ahyf.2020.02.002
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参考文献
[1] Zhu N,Zhang D,Wang W,et al.A novel coronavirus from patients with pneumonia in China,2019[J].N Engl J Med,2020.DOI: 10.1056/NEJMoa2001017.
[2] 国际病毒分类委员会将新型冠状病毒命名为SARS-CoV-2[OL].http://www.chinanews.com/gj/2020/02-12/9088314.shtml.
[3] 国家卫生健康委办公厅.新型冠状病毒肺炎防控方案(第五版)[M].(2020-02-05).
[4] 医政医管局.新型冠状病毒肺炎诊疗方案(试行第六版)[BE/OL].[2020-02-18].http://www.nhc.gov.cn/yzygj/s7653p/202002/8334a8326dd94d329df351d7da8aefc2/files/b218cfeb1bc54639af227f922bf6b817.pdf.
[5] 中华人民共和国国家卫生健康委员会.新型冠状病毒感染的肺炎纳入法定传染病管理[EB/OL].(2020-01-20)[2020-02-05].http://www.nhc.gov.cn/jkj/s7916/202001/44a3b8245e8049d2837a4f27529cd386.shtml.
[6] Chu DKW,Pan Y,Cheng SMS,et al.Molecular diagnosis of a novel coronavirus (2019-nCoV) causing an outbreak of pneumonia[J].Clin Chem,2020,doi:10.1093/clinchem/hvaa029.
[7] Yu F,Du L,Ojcius DM,et al.Measures for diagnosing and treating infections by a novel coronavirus responsible for a pneumonia outbreak originating in Wuhan,China[J].Microbes Infect,2020,doi:10.1016/j.micinf.2020.01.003.
[8] 中华人民共和国国家卫生健康委员会.中华人民共和国国家卫生健康委员会公告(2020 年第1 号)[BE/OL].(2020-01-20)[2020-02-14].http://www.nhc.gov.cn/jkj/s7916/202001/44a3b8245e8049d2837a4f27529cd386.shtml.
[9] 中华人民共和国国家卫生健康委员会.新型冠状病毒感染的肺炎实验室检测技术指南(第三版)[S/OL].(2020-01-28)[2020-01-28].http://www.nhc.gov.cn/jkj/s7923/202001/470b128513fe46f086d79667db9f76a5.shtml.
[10] Kelvin Kai-Wang To,Owen Tak-Yin Tsang,et al.Consistent Detection of 2019 Novel Coronavirus in Saliva,Clinical Infectious Diseases,2020;XX(XX):1-3,DOI: 10.1093/cid/ciaa149.
[11] Zhang H,Kang Z,Gong H,et al.The digestive system is a potential route of2019-nCoV infection: A bioinformatics analysis based on single-cell transcript tomes[Z].Biorxiv,2020,https://doi.org/10.1101/2020.01.30.927806.
[12] Zhou P,Yang X,Wang X,et al.Discovery of a novel coronavirus associated with therecent pneumonia outbreak in humans and its potential bat origin[Z].BioRxiv,2020,https://doi.org/10.1101/2020.01.22.914952.
[13] Xu X,Chen P,Wang J,et al.Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission[J].SCIENCE CHINA-LIFE SCIENCES,2020.
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