普通病毒学(英文版)《GENERAL VIROLOGY》翻译,快速诊断.docVIP

《GENERAL VIROLOGY》 《普通病毒学》 18. DIAGNOSTIC VIOLOGY 第18章 诊断病毒学 Page：514-526 Rapid Diagnosis 快速诊断 Rapid diagnosis of both HSV and VZV infections can be accomplished by FA staining. For this technique, cells from the base of a lesion are obtained by scraping the base with a scalpel blade or rubbing vigorously with a Dacron or rayon swab, and placing the material obtained on one or more microscope slides. This material is air dried, fixed with acetone, and then stained with fluorescent-labeled monoclonal antibodies to HSV and VZV. This technique is particularly advantageous for VZV because of the difficulty of culturing that virus . FA staining is preferable to a Tzanck smear because it allows specific viral identification and is more sensitive. PCR can be used to detect HSV or VZV DNA in cutaneous lesions with greater sensitivity than cell culture. 通过FA 染色可以实现对HSV和VZV感染的快速诊断。这种方法，用手术刀片刮或用涤纶、人造丝拭子用力摩擦来制造病变，并从病变基处来获得细胞。放置在一个或几个载玻片上，材料干燥后,用丙酮固定, 然后以荧光标记的 HSV和VZV的单克隆抗体染色。 这种方法对较难培养的VZV更为有利。FA染色是一种较好的Tzanck涂片方法，因为它能够对特定的病毒进行检测并且敏感性较高。PCR的方法用来检测病变皮肤中的HSV 或VZV DNA比细胞培养的方法更敏感。 Serology 血清学 Serology has little role in the diagnosis of acute HSV infection because viral culture or antigen detection is usually successful, because serology requires acute and convalescent phase specimens, and because of difficulties in interpretation related to cross-reactions as well as asymptomatic reactivations. VZV serology is occasionally useful for diagnosis of acute VZV if appropriate specimens were not obtained for culture and antigen detection or if those tests were negative despite a clinical impression that VZV was the true diagnosis. Detection of seroconversion is the strongest serologic evidence of infection, although detection of VZV-specific IgM antibodies also supports the diagnosis of recent infection. Virus-specific IgM antibodies can be present with reactivation (zoster) as well as with primary infection. 血清学检测对急性HSV感染的诊断意义较小。因为血清学检测需要有急性期的和恢复期的标本，而且难以解释交叉反应和阴性感染。通过病毒培养或抗原检测则往往更易成