伤寒LPS-PHA快速诊断试剂盒的评价

本文对伤寒LPS-PHA诊断试剂盒进行现场应用评价.来自各医院和不同地区977份不同类型的血清标本作LPS-PHA检测的同时与Widal试验作比较,结果伤寒沙门氏菌血培养阳性46份血清标本前者检出率(86.96％)显著高于后者(67.39％),两者在统计学上有显著差异(X~2=4.999,P<0.025),95份Widal试验阳性血清LPS-PHA阳性率为97.89％,漏检2份系乙型副伤寒抗体阳性者.607份对照血清标本LPS-PHA的假阳性率1.48％,低于Widal试验(4.84％).伤寒LPS-PHA的敏感度和特异度(94.33％和98.52％)高于Widal试验(89. 36％和95.72％).其他5项评价指标(阳性和阴性预示值,粗一致性,调整一致性和约登指数)亦都较Widal试验好.因此,LPS-PHA诊断试剂盒能满足目前临床上早期快速诊断伤寒的要求.但不适用于追溯诊断和血清流行病学调查.

Evaluation on Rapid LPS-PHA Diagnostic Kit of Typhoid Fever

The rapid LPS-PHA kit of typhoid fever was made as an on-the-spot evaluation. Serum samples from dif-ferent hospitals and areas were detected by LPS-PHA,and compared with Widal's test. The results show LPS-PHA has a high detecting rate of 86. 96%,whereas Widal's test only of 67. 39%(X~2=4. 999,P<0.025) in 46sera with typhi blood culture positive. In addifion, 97.89% of 95 Widal's test positive sera in which 2 para ty-phoid B antibody positive sera haven't been detected. LPS-PHA false-positive rate of 607 control sera is 1. 48%,lower than in the Widal'stest(4. 84%). The sensitivity and specificity (94. 33% and 98. 52%)are higherthan the Widal's test (89. 36% and 95. 72%) and the other five evalution standards (positive and negative pre-dictive value, crude and adjusted agreement, youden's index) are also better than Widal's test. Therefore, LPS-PHA could be satisfied with the demand of early rapid clinical diagnosis of typhoid fever. But this kit couldn't beuse(?) in trace back diagnosis and investigation of serum epidemiology.