细胞分离培养在实验室诊断眼部单纯疱疹病毒感染疾病的误诊和漏诊情况(英文)
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R771.3

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Cell culture isolation can miss the laboratory diagnosis of HSV ocular infection
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    摘要:

    目的:对比聚合酶链反应(PCR)和细胞分离培养在实验室诊断眼部单纯疱疹病毒(HSV)感染疾病的作用。方法:我们对连续患者的实验室结果(PCR实验,细胞分离培养及临床诊断)及病历进行回顾性研究在诊断眼部HSV感染疾病过程中,PCR检测结果、细胞分离培养及首诊结果进行了统计比较。结果:患者581例经过检查后,520例PCR检查阴性,细胞培养阴性(89.6%);0例PCR检查阴性,细胞培养阳性(0%);27例PCR检查阳性,细胞培养阴性(4.6%);34例PCR检查阳性,细胞培养阳性(5.8%)。PCR检测阳性率高于细胞分离培养(McNemars,P=0.0001)。47例PCR检查为HSV初诊感染阳性患者中,19例患者中有14例为细胞培养阴性结果(74%),5例HSV患者因缺PCR检测结果将被误诊;28例患者中有25例患者细胞培养阳性(占89%),3例HSV患者因缺PCR检测结果将被漏诊。结论:PCR诊断眼部HSV感染优于细胞分离培养。细胞分离培养对于眼部HSV感染的非典型表现不易诊断。

    Abstract:

    ·AIM:We compared polymerase chain reaction(PCR)to cell culture isolation for the laboratory diagnosis of ocular herpes simplex virus(HSV)disease.·METHODS:Laboratory and medical records of consecutive patients were reviewed for results of(1)HSV PCR testing,(2)HSV cell culture isolation,and(3)clinical diagnosis.PCR results were statistically compared to cell culture isolation and patients initially diagnosed for ocular HSV infection.·RESULTS:Of 581 cases submitted for laboratory testing,520 were PCR negative,cell culture negative(89.6%);0 was PCR negative,cell culture positive(0%);27 were PCR positive,cell culture negative(4.6%);and 34 were PCR positive,cell culture positive(5.8%).PCR tested more positive than cell culture isolation(McNemar’s,P=0.0001).Of 47 HSV PCR positive cases with complete medical records,19 were cell culture negative for HSV and 28 were cell culture positive for HSV.Fourteen of 19 cell culture negative cases(74%)(Without PCR,5 cases of HSV would be missed)and 25 of the 28 cell culture positive cases(89%)(Laboratory testing was necessary for diagnosing 3 cases)were clinically diagnosed with HSV at the initial examination.·CONCLUSION:PCR was a more definitive test for diagnosing HSV ocular infection than cell culture isolation.Cell culture isolation alone can miss an atypical presentation of HSV ocular infection.·

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Regis P Kowalski, Paul P Thompson, Tara H Cronin.细胞分离培养在实验室诊断眼部单纯疱疹病毒感染疾病的误诊和漏诊情况(英文).国际眼科杂志, 2010,10(11):2045-2048.

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