| [Background]In recent years,some infectious diseases with the main clinical manifestations of fever,gastrointestinal symptoms,platelet and leucocyte decrease have been Subsequently found and reported in henan,hubei,shandong,jiangsu,zhejiang and other regions of China.In May 2010,the experts of Chinese Center for Disease Control and Prevention isolated a new virus,which is named severe fever with thrombocytopenia syndrome virus,the disease caused by this virus is named severe fever with thrombocytopenia syndrome.At present,the two most common methods for early diagnosis of SFTSV are real-time PCR and ELISA.Due to the principle?purpose and clinical significance of the two methods are not same,it has important guiding significance in actual work to explore the differences of two methods,and the relationship between the sampling time and experimental results.[Objectives]Do some research about the relationship between the sampling time and the ratio of virus detection of severe fever with thrombocytopenia syndrome,which will provide the basis for the optimum sampling time.Compare the differences between real-time PCR method and ELISA,discusses the application value in detecting severe fever with thrombocyto-penia syndrome.Analys the epidemiological features of severe fever with thrombocytopen-ia syndrome in Shandong province,to provide a scientific basis for preventionand control.[Methods]1.Collect the serum samples of suspected cases fome hospitals in shandong province,from January 2013 to December 2013,records the onset time and sampling time.detect the virus RNA in serum and analyze the relationship between the ratio of virus nucleic acid detection and the serum sampling time.2.Randomly selected 95 cases of SFTS acute phase serum samples.Detect the virus RNA in serum by real-time PCR.Detect the IgM?IgG and total antibody in serum by ELISA.Compare the effect of several detection methods by statistical methods.3.Collecte the epidemiological data of severe fever with thrombocytopenia syndrome in shandong province,analyzing its distribution characteristics by using descriptive epidemiological methods.[Results]1.Basing on the statistics and analysis of the relationship between the number of days that the patient is sick and SFTSV nucleic acid detection?we find that positive nucleic acid could be detected in serum during 0?38 days of patients with fever with SFTS incidence,Virus nucleic acid in the blood can be detected in 55.47%of cases in 4?8 days and 14d after onset and nucleic acid detection positive rate is extremely low.2.After testing 95 specimens,39 cases of IgM and 4 cases of IgG are positive,and 29 cases of total antibody are positive.The Kappa number between the results of PCR and IgM is 0.286,proving the degree of consensus between two kinds of test method is good;The Kappa number between the results of PCR and IgG is negative,proving the result of two methods is inconsistent;The Kappa number between the results of PCR and total antibody is negative,proving the result of two methods is inconsistent;The Kappa number between the results of total antibody and IgM is 0.5021,proving the degree of consensus between two kinds of test method is medium;The Kappa number between the results of total antibody and IgG is 0.1164,proving the degree of consensus between two kinds of test method is light.3.The morbidity of SFTS in Shandong province in 2013?2015 are different between each year,each month,and in different cities.The difference is of statistica significance;The reported cases it takes on obvious seasonal characteristic in the reported cases,which accounted for 75.6%in the report of 5?8 month.40?79-year-old age group is in the majority of the cases,most of whom are farmers.40?79-year-old age group,the fatality rate is higher especially in group of the population aged over 60.[Conclusions]1.959 serum samples of suspected SFTS cases in shandong province were collected from January 2013 to December 2013 in shandong province,and testing by Real-time PCR.The positive number is 519,the positive rate is 54.11%.Through to the statistics and anslysis of relationship between the number of days the patient is sick and the nucleic acid testing positive,In patients with SFTS of 0?19 days,SFTSV positive nucleic acid in serum can be detected.the positive rate of detection is higher in the 3?8 days,the 7 days is highest,reach to 64.52%.8 days after onset of blood test positive rate is falling,the onset of 14 days in pursuance of the detection positive rate is very small.2.Real-time fluorescence PCR method should be the first to use in the early diagnosis of severe fever with thrombocytopenia syndrome cases,and the method of ELISA-IgM is a necessary supplement,which will become a more appropriate diagnostic tool with the extension of the disease.3.The Cases of SFTS in Shandong province mainly occurred in the middle and old aged people in Hilly Area in Shandong province.There was no statistically significance at Gender difference.It shows that the obvious characteristics of Seasonal distribution in the cases,and there are differences in different areas.It is suggested that health education and propaganda should be carried out in the early stage of disease epidemic at the key areas among focus groups,which is an important prevention and controling measures to the occurrence of disease. |
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