床旁测定用唾液样本诊断呼吸道病毒
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By LabMedica International staff writers Posted on 01 Aug 2018 |
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图片：Xpert Xpress流感/RSV测定盒（图片蒙Cepheid公司惠赐）。
有人提议用唾液作为样本检测呼吸道病毒，替代鼻咽抽吸物或鼻咽拭子样本：唾液的优势为引起患者的不适较轻，对医疗工作者造成的风险更小。
自动化床旁分子测定极大缩短了呼吸道病毒化验的运行时间。现在的主要瓶颈之一是样本收集这一步，尤其是在繁忙的临床场合。唾液是一种方便的样本，成人患者可轻松获取。
香港大学(www.hku.hk)的科学家在2017年7至10月间招募了214名患者，并开展了一项前瞻性诊断确证研究，用美国加利福尼亚州森尼韦尔市Cepheid公司(www.cepheid.com)的Xpert Xpress流感/RSV产品检测住院成人患者的唾液和鼻咽抽吸物(NPA)，比较两者对呼吸道病毒的检测率。还估计了收集唾液与鼻咽样本所需的成本和时间。
科研小组发现，唾液与NPA之间的总体一致率为93.3% (196/210)。二者检测呼吸道病毒的检测率无显著差异，前者为69/210 (32.9%)，后者为75/210 (35.7%)。唾液的总灵敏度与特异性分别为90.8% (81.9-96.2%)与100% (97.3-100%)，NPA的总灵敏度与特异性分别为96.1% (88.9-99.2%)与98.5% (94.7-99.8%)。收集NPA的时间与成本分别是收集唾液的时间与成本的2.3倍和2.6倍。
该研究的论文发表于2018年6月12日的《临床微生物学与传染》(Clinical Microbiology and Infection)杂志。作者总结说，这款自动化多重床旁分子测定获得了临床实验室改进修正案(CLIA)标准的豁免权，使用唾液样本检测呼吸道病毒的灵敏度与特异性高于NPA。使用唾液还缩短了收集样本所需时间，降低了成本。
香港大学>>> www.hku.hk
Cepheid >>> www.cepheid.com
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