流感病毒PCR方式與快篩檢測之相關性研究

流行性感冒是社區中常見的傳染病，其高度傳染性，很容易造成社區流行，而澳門人口密度高，也是流感好發地區，因此不能忽視流感的影響。早期診斷有助於流感的防治，目前各地主要使用的實驗室檢測方法為反轉錄聚合酶連鎖反應技術以及快篩檢驗。流感快篩檢驗包括傳統抗原檢測(RIDTs)及快速核酸擴增技術(rapid NAATs)，二者均能在短時間內直接檢測檢體中是否存在流感病毒。為了解各流感快篩檢測的檢測性能、發展趨勢及臨床應用價值，本研究以文獻探討方式，對相關文獻進行綜合整理，從效能及成本方面分析，探討流感PCR與快篩檢測之相關性。根據目前國外的研究資料顯示，不同廠牌的傳統抗原檢測在敏感度上有很大差異，但整體敏感度偏低，而快速核酸擴增技術的敏感度則較傳統抗原檢測高；另外，採用快速核酸擴增技術能有助於縮短患者的急診逗留時間，或住院時間以及減少額外輔助診斷的開立。本文建議在本澳診斷及治療流感上，可結合流感流行率來判斷是否採用實驗室方法，以及考慮根據流行率來調整抗病毒藥物的使用條件，以保障患者健康，及對醫院達至最大的成本效益。本研究擬針對研究結果向衛生醫療單位提出建議，在檢驗方法的選擇上提供參考，盼協助單位在流感病毒防治上的執行工作。

關鍵字

流行性感冒；流感快篩檢測；流感核酸擴增技術；成本效益

並列摘要

Influenza is a common highly infectious disease in crowded communities such as in Macau. Early diagnosis is crucial in treating influenza. The laboratory diagnostic methods mostly used are RT-PCR and rapid screening tests. Influenza rapid screening tests included Rapid Influenza Diagnostic Test (RIDTs) and rapid nucleic acid amplification technique (rapid NAATs). Both tests can detect the presence of influenza directly in the sample within a short period of time. In order to understand the performance, development trend and clinical application value of different influenza tests, the aim of this study was to investigate the correlations between Influenza PCR and rapid screening tests by literature reviews and performance and cost analysis reviews. According to recent studies, different brands of RIDTs differ greatly in sensitivity. RIDTs have lower overall sensitivity compared to rapid NAATs. Furthermore, rapid NAATs could decrease the medical cost and shorten patients staying time in ER or hospital. Rapid NAATs could also reduce extra diagnostic tests. Finally, the study suggested that the decision-making strategy for influenza testing could involve the prevalence rate of influenza, which, could also be a consideration factor for adjusting the prescription of anti-viral drugs. The results of this study could give suggestions to the healthcare unit for more understanding and executing on influenza prevention and influenza tests selection.