CN116179646A - 一种***炎多联检试剂盒 - Google Patents

一种***炎多联检试剂盒 Download PDF

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CN116179646A
CN116179646A CN202211611774.9A CN202211611774A CN116179646A CN 116179646 A CN116179646 A CN 116179646A CN 202211611774 A CN202211611774 A CN 202211611774A CN 116179646 A CN116179646 A CN 116179646A
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刘志磊
杨红云
王则宇
杨森
杨静静
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Autobio Diagnostics Co Ltd
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Priority to CN202311178766.4A priority patent/CN117004685A/zh
Priority to CN202311178769.8A priority patent/CN117265066A/zh
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Abstract

本发明公开了一种***炎多联检试剂盒,包括具有多个反应孔的反应板,反应孔包含过氧化氢反应孔、精氨酸氨基肽酶反应孔、凝固酶反应孔、脯氨酸氨基肽酶反应孔、唾液酸苷酶反应孔、乙酰氨基葡萄糖苷酶反应孔、高浓度过氧化氢反应孔、pH反应孔、白细胞酯酶反应孔和葡萄糖苷酶反应孔。本发明试剂盒中的精氨酸氨基肽酶与过氧化氢相结合,可确定样本中是否存在需氧菌性***炎,提高了需氧菌性***炎的灵敏性和准确性;本发明通过致病菌感染情况区分BV、VVC、TV、AV和CV五种***感染性疾病,适用于临床上***混合感染样本的快速检测,多个指标相互结合确定致病菌,避免单独观察单一指标产生的片面性和干扰因素,提高检测结果的可靠性。

Description

一种***炎多联检试剂盒
技术领域
本发明涉及体外诊断试剂领域,尤其是涉及一种***炎多联检试剂盒。
背景技术
***是女性下生殖道免疫防御***的第一道屏障,是生理性开放的器官,健康育龄期女性***微环境是由以乳杆菌为优势菌群,多种厌氧菌及需氧菌共同组成的微生态动态平衡***,其中乳杆菌通过分解糖原产生乳酸、过氧化氢等多种机制抑制其他细菌的过度繁殖,在***自净、维持女性***健康状态中起关键作用。然而,这种微生态平衡***受外界因素很容易被打破,如药物、吸烟、机体免疫状态和***等因素。女性的***微生态平衡***一旦被打破,将会引起致病菌的过度繁殖,进而引起各种***疾病,主要表现为***分泌物异常、外阴瘙痒灼痛等症状。
常见的***感染性疾病主要包括细菌性***病(BV)、霉菌性***炎(VVC)(又称外阴***假丝酵母菌)、滴虫性***炎(TV)、需氧菌性***炎(AV)、细胞溶解性***病(CV)。目前,***感染常用的检测方法和技术手段为显微镜镜检和干化学酶法诊断试剂。其中,显微镜镜检虽然具有较好的特异性,但该检测方式主观性比较强,容易漏检,且长时间观察也容易引起视觉疲劳。因而,目前大多采用以基于干化学酶法的诊断试剂盒来进行检测。现有的干化学酶法诊断试剂盒大多数只能检测细菌性***病、霉菌性***炎(外阴***假丝酵母菌引起的***炎)和***毛滴虫病;极少数试剂盒可以检测需氧菌性***炎,但即便能检测,结果的可靠性比较差;另外,现今没有干化学酶法试剂可以检测细胞溶解性***病,进而导致出现严重的漏检情况。
发明内容
鉴于此,本发明提供了一种***炎多联检试剂盒,不仅具有较高的灵敏度、特异性和稳定性,提高了检测结果的准确性和可靠性,还能精准区分BV、VVC、TV、AV和CV,适用于***感染的快速检测,具有很大的推广价值。
为实现上述目的,本发明采取下述技术方案:
本发明所述的***炎多联检试剂盒,包括具有多个反应孔的反应板,所述反应孔依次为过氧化氢反应孔、精氨酸氨基肽酶反应孔、凝固酶反应孔、脯氨酸氨基肽酶反应孔、唾液酸苷酶反应孔、乙酰氨基葡萄糖苷酶反应孔、高浓度过氧化氢反应孔、pH反应孔、白细胞酯酶反应孔和葡萄糖苷酶反应孔;
所述过氧化氢反应孔的稳定保护剂为抗坏血酸;
所述高浓度过氧化氢孔的稳定保护剂为焦亚硫酸钠;
所述精氨酸氨基肽酶反应孔的显色底物为含有色原的L-精氨酸单肽底物。
在上述方案中,抗坏血酸的浓度优选为5-50mg/L,溶剂为PBS缓冲液;焦亚硫酸钠的浓度为0.03-0.2g/L,溶剂为柠檬酸盐缓冲液。
在本发明中,含有色原的L-精氨酸单肽底物的浓度为0.2-0.8g/L,溶剂为Tris-柠檬酸缓冲液;所述精氨酸氨基肽酶反应孔的稳定剂保护液为30-50g/L蔗糖。所述精氨酸氨基肽酶反应孔的检测限浓度为7 U/mL,该反应孔可与过氧化氢氧化孔结合来判读需氧菌性***炎。
在本发明中,含有色原的L-精氨酸单肽底物优选为L-精氨酸-β-萘胺盐酸盐。
在本发明中,所述试剂盒还包括稀释液和用于终止精氨酸氨基肽酶反应孔、脯氨酸氨基肽酶反应孔和凝固酶反应孔反应的终止液,所述稀释液为含有甘露醇浓度为0.1%~3%的0.9%氯化钠溶液。采用含有甘露醇的0.9%氯化钠溶液作为样本稀释液,有效提高显色结果的可读性,进而提高检测结果的可靠性。
在本发明中,所述终止液为酸性终止液。更优选的,所述酸性终止液为含有0.01%-0.2% 4-二甲氨基肉桂醛的盐酸,且所述盐酸的浓度为0.5~2.0M。
更优选的,所述过氧化氢反应孔包被的反应底物还包括过氧化物酶50-200kU/L、4-氨基安替比林0.3-1g/L,TOOS 1-4g/L,溶剂为PBS缓冲液;
所述高浓度过氧化氢反应孔包被的反应底物还包括过氧化物酶50-200kU/L、4-氨基安替比林0.3-1g/L,TOOS 1-4g/L,溶剂为柠檬酸盐缓冲液。
在本发明中,所述唾液酸苷酶反应孔的底物反应试剂为含有色原的神经氨酸盐,所述含有色原的神经氨酸盐的配制溶剂是由无水乙醇和柠檬酸盐缓冲液混合而成;其中,在实际配制时无水乙醇和柠檬酸盐缓冲液的体积比优选为1:1;
所述葡萄糖苷酶反应孔的底物反应试剂为浓度为含有色原的葡萄糖苷,所述含有色原的葡萄糖苷采用PBS缓冲液配制而成;
所述pH反应孔的底物反应试剂为溴甲酚绿和 NaOH;其中,溴甲酚绿的浓度优选为0.05-1.5g/L,NaOH溶液的浓度优选为0.05mol/L;
所述白细胞酯酶反应孔的底物反应试剂为5-溴-4-氯-3-吲哚乙酸盐溶液,其中5-溴-4-氯-3-吲哚乙酸盐溶液的溶剂为甲醇和柠檬酸盐缓冲液混合而成,甲醇和柠檬酸盐缓冲液的体积比优选为1:1;
其中,唾液酸苷酶反应孔、葡萄糖苷酶反应孔、pH反应孔和白细胞酯酶反应孔的稳定剂保护液均为20-50g/L D-山梨醇水溶液。
与现有技术相比,本发明的试剂盒具有以下优点:
本发明试剂盒中的精氨酸氨基肽酶与过氧化氢相结合,能够确定样本中是否存在需氧菌,极大地提高了需氧菌性***炎的灵敏性和准确性;并且本发明通过精氨酸氨基肽酶反应孔和过氧化氢反应孔的颜色变化情况判断,结果直观,不需要经验,且结果客观可重复。
本发明的高浓度过氧化氢反应孔和pH反应孔相结合,能够确定样本中的过氧化氢浓度和pH,极大地提高了细胞溶解性***病的灵敏性和准确性;另外,通过显示结果进行判读,结果直观,结果客观可重复。
本发明能同时检测样本中的过氧化氢、精氨酸氨基肽酶、凝固酶、脯氨酸氨基肽酶、唾液酸苷酶、乙酰氨基葡萄糖苷酶、高浓度过氧化氢、pH、白细胞酯酶和葡萄糖苷酶,可以准确确定样本中的致病菌,进而可通过致病菌感染情况区分细菌性***病、霉菌性***炎、滴虫性***炎、需氧菌性***炎、细胞溶解性***病,特别适用于临床上***混合感染样本的快速检测。本发明试剂盒中的多个指标相互结合确定致病菌,避免了单独观察单一指标产生的片面性和干扰因素,提高了检测结果的可靠性。
本发明试剂盒操作简单且具有较高的灵敏度、特异性和稳定性,能实现***混合感染样本的快速联检并将检测结果控制在5min以内,不仅适用于医院,也适用于居家使用,具有很大的推广价值。
具体实施方式
下面通过具体实施例对本发明做更加详细的说明,以便于本领域技术人员的理解。需要说明的是,如无特殊说明,本发明所用的试剂均为可以购买得到的常规试剂,采用的仪器和方法也为本领域常规仪器和方法。另外,稳定剂保护液D-山梨醇溶液、蔗糖溶液、D-半乳糖溶液和海藻糖溶液均是采用蒸馏水配制而成。
实施例1 本发明所述的***炎多联检试剂盒
本发明的***炎多联检试剂盒,包括反应板、终止液和稀释液,反应板具有十个反应孔,十个反应孔分别为过氧化氢反应孔、精氨酸氨基肽酶反应孔、凝固酶反应孔、脯氨酸氨基肽酶反应孔、唾液酸苷酶反应孔、乙酰氨基葡萄糖苷酶反应孔、高浓度过氧化氢反应孔、pH反应孔、白细胞酯酶反应孔和葡萄糖苷酶反应孔。
具体地,过氧化氢反应孔内包被的底物试剂是含过氧化物酶50-200kU/L、4-氨基安替比林0.3-1g/L和TOOS 1-4g/L的PBS缓冲液;该反应孔的稳定剂保护液是抗坏血酸的PBS缓冲液,抗坏血酸的浓度为5-50mg/L。
高浓度过氧化氢反应孔内包被的底物试剂是采用柠檬酸盐缓冲液(pH为5-7、浓度为0.1-0.5 M)、过氧化物酶、4-氨基安替比林和TOOS配制而成,其中过氧化物酶的浓度为50-200kU/L、4-氨基安替比林的浓度为0.3-1g/L,TOOS的浓度为1-4g/L;该反应孔的稳定剂保护液是焦亚硫酸钠0.03-0.2g/L,溶剂为柠檬酸盐缓冲液,该反应孔可用于过氧化氢浓度≥10mg/L的高浓度样本。
精氨酸氨基肽酶反应孔内包被的底物试剂为含有色原的L-精氨酸单肽底物。其中在本实施例中含有色原的L-精氨酸单肽底物优选浓度为0.2-0.8g/L的L-精氨酸-β-萘胺盐酸盐溶液,其采用Tris-柠檬酸缓冲液(浓度为0.1-0.5mol/L,pH为6.0-8.5)配制而成;该反应孔的稳定剂保护液为30-50g/L蔗糖溶液。
pH反应孔内包括的底物试剂是包括溴甲酚绿0.05-1.5g/L和0.05mol/L NaOH(采用蒸馏水配制而成);该反应孔的稳定剂保护液为20-50g/L D-山梨醇。
凝固酶反应孔内包被的底物试剂为浓度为2-10g/L的L-甘氨酸-精氨酸-β-萘胺盐酸盐,由柠檬酸盐缓冲液(浓度为0.1-0.5 M,pH=3.0-6.0)配制而成;该反应孔的稳定剂保护液为20-50g/L海藻糖溶液。
脯氨酸氨基肽酶反应孔内包被的底物反应试剂是由Tris-HCl缓冲液(浓度为0.1-0.5mol/L,pH为6.0-8.5)配制而成的 L-脯氨酸-β-萘胺盐酸盐,浓度为0.2-2 g/L;该反应孔的稳定剂保护液为20-50 g/L海藻糖溶液。
唾液酸苷酶反应孔内包被的底物试剂为含有色原的神经氨酸盐。其中,在本实施例中含有色原的神经氨酸盐优选浓度为0.15-3g/L的5-溴-4-氯-3-吲哚神经氨酸盐(当然,5-溴-4-氯-3-吲哚神经氨酸盐也可以替换为其它含有色原的神经氨酸盐),该底物试剂是采用乙醇-柠檬酸盐缓冲溶液配制而成,其中,乙醇-柠檬酸盐缓冲溶液的体积比为1:1,柠檬酸盐溶液的浓度为0.1-0.5M,pH为4.0-6.0 ;该反应孔的稳定剂保护液为20-50g/L D-山梨醇溶液。
乙酰氨基葡萄糖苷酶反应孔内包被的反应试剂是浓度为0.2-2g/L的6-氯-3-吲哚-2-乙酰氨基-2-脱氧基-β-D-葡萄糖苷,采用PBS缓冲液(浓度为0.1-0.5 M,pH为4.0-6.0)配制而成;该反应孔的稳定剂保护液为20-50g/L D-半乳糖。
白细胞酯酶反应孔内包被的底物试剂为浓度为0.1-6g/L的5-溴-4-氯-3-吲哚乙酸盐,是采用甲醇-柠檬酸盐缓冲溶液(甲醇和柠檬酸盐缓冲溶液的体积比为1:1,柠檬酸盐缓冲溶液的浓度为0.1-0.5M,pH为5.0-7.0)配制而成;该反应孔的稳定剂保护液为20-50g/L D-山梨醇溶液。
葡萄糖苷酶反应孔内包被的底物反应试剂为含有色原的葡萄糖苷。其中,在本实施例中含有色原的葡萄糖苷优选浓度为0.5-3g/L的6-氯-3-吲哚-a-D-葡萄糖苷溶液(当然,6-氯-3-吲哚-a-D-葡萄糖苷也可替换为其它含有色原的葡萄糖苷),其采用PBS缓冲液(浓度为0.1-0.5 M,pH为4.0-6.0)配制而成;该反应孔的稳定剂保护液为20-50g/L D-山梨醇溶液。
稀释液(封装在试剂瓶内)用于涮洗***分泌物拭子,该稀释液为含有甘露醇的0.9%氯化钠溶液,甘露醇的浓度为0.1%~3%(质量百分数)。
在检测时,精氨酸氨基肽酶、脯氨酸氨基肽酶和凝固酶三个指标对应有终止液(封装在试剂瓶内),以提高检测结果的精准性。其中,本发明的终止液为酸性终止液,具体为含有0.01%-0.2%4-二甲氨基肉桂醛(质量分数)的盐酸,盐酸的浓度为0.5~2.0M。
实施例2 本发明试剂盒的使用方法
本发明试剂盒的使用方法,包括以下步骤:
将***分泌物拭子用500 -1000μL稀释液洗脱,得到稀释后的样本;
在每个反应孔内分别滴加30-35μL稀释后的样本,常温或者37℃静置10-20分钟;
静置结束后,向精氨酸氨基肽酶反应孔、脯氨酸氨基肽酶反应孔和凝固酶反应孔内分别加入25 μL酸性终止液终止反应;
根据试剂盒配套的比色卡进行结果判读:
过氧化氢指标:紫色或淡紫色指示阴性;不显色指示阳性;
高浓度过氧化氢指标:正常不显色;红色代表阳性;
pH指标:黄色或绿色说明pH≤4.6,蓝色代表pH≥4.8;
精氨酸氨基肽酶指标:正常不显色或近白色,红色代表阳性;
凝固酶指标:正常不显色或近白色,红色代表阳性;
脯氨酸氨基肽酶:正常不显色或近白色,红色代表阳性;
唾液酶指标:正常不显色或近白色,红色代表阳性;
乙酰氨基葡萄糖苷酶指标:正常不显色,代表阴性;红色代表阳性;
白细胞酯酶指标:正常不显色或为浅蓝色;蓝色代表阳性,提示样本中白细胞≥15个/HP视野,且白细胞越多蓝色越深;
葡萄糖苷酶指标:正常不显色;红色代表阳性。
在上述指标中,脯氨酸氨基肽酶和唾液酸苷酶中的一种或两种阳性,表示细菌性***病感染;凝固酶和葡萄糖苷酶同时阳性且pH值≤4.6或乙酰氨基葡萄糖苷酶阳性且pH值≤4.6,表示外阴***假丝酵母菌感染;凝固酶和葡萄糖苷酶同时阳性且pH值≥4.8,或乙酰氨基葡萄糖苷酶阳性且pH值≥4.8,表示滴虫感染;精氨酸氨基肽酶阳性且过氧化氢阳性,表示感染需氧菌性***炎;高浓度过氧化氢阳性且pH值≤4.1,表示感染细胞溶解性***病。
本发明的试剂盒具有过氧化氢、精氨酸氨基肽酶、凝固酶、脯氨酸氨基肽酶、唾液酸苷酶、乙酰氨基葡萄糖苷酶、高浓度过氧化氢、pH、白细胞酯酶和葡萄糖苷酶十个指标相结合,不仅能区分细菌性***病BV、霉菌性***炎VVC、滴虫性***炎TV和需氧菌性***炎AV、细胞溶解性***病CV,还能将这些指标相互结合提高检测准确率,避免了单独观察单一指标产生的片面性和干扰因素,提高了临床上***混合感染的检测结果更加准确。
实施例3 本发明试剂盒的检测限
本实施例以精氨酸氨基肽酶为例,确定了每个指标的检测限浓度。具体地,配制不同浓度梯度的精氨酸氨基肽酶质控品,向精氨酸氨基肽酶反应孔内滴加精氨酸氨基肽酶质控品,观察该反应孔的显色变化结果,以确定精氨酸氨基肽酶反应孔的检测限,各反应孔对应的最低显色检测限见表1。
表1 本发明试剂盒的检测限
Figure DEST_PATH_IMAGE002
另外,当过氧化脲浓度为10mg/L及其以上浓度时,过氧化氢指标为阴性,高浓度过氧化氢指标阳性,完全不影响结果判读。
实施例4 本发明试剂盒的特异性
本实施例分别以0.5麦氏大肠杆菌和0.5麦氏金黄色葡萄球菌考察本发明试剂盒中过氧化氢反应孔、凝固酶反应孔、脯氨酸氨基肽酶反应孔、唾液酸苷酶反应孔、乙酰氨基葡萄糖苷酶反应孔、高浓度过氧化氢反应孔、白细胞酯酶反应孔和葡萄糖苷酶反应孔的特异性,用白色念珠菌作为干扰考察本发明试剂盒中精氨酸氨基肽酶反应孔的特异性,结果见表2。
表2 本发明试剂盒的特异性
Figure DEST_PATH_IMAGE004
由上表2可知,本发明试剂盒中的每个反应孔均具有较好的特异性,并且本发明试剂盒在常温存放半年后依然表现出很好的特异性,也说明本发明试剂盒稳定性良好,确保检测结果的精准性,能够满足临床上***混合感染的检测需求。
实施例5 本发明试剂盒的稳定性
本实施例用实施例3得到的检测限质控品作为样本,考察本发明试剂盒的稳定性,结果见表3。
表3 本发明试剂盒的稳定性
Figure DEST_PATH_IMAGE006
由表3可知,本发明试剂盒在常温放置6个月后,各反应孔的显色情况和常温放置0天时的显色结果一致,说明本发明试剂盒中十个反应孔均具有较好的稳定性。另外,结合表2可知,本发明试剂盒在常温放置半年后,各反应孔并不受干扰菌的影响,进一步说明本发明试剂盒具有很好的稳定性。
实施例6 本发明试剂盒的准确率
本发明同时用革兰氏染色显微镜镜检和本发明实施例1制备得到的试剂盒分别对临床上212例***分泌物样本进行对比,结果见表4和表5。
表4 本发明和革兰氏染色显微镜镜检对AV***炎的检测结果
Figure DEST_PATH_IMAGE008
表5 本发明和革兰氏染色显微镜镜检对CV***炎的检测结果
Figure DEST_PATH_IMAGE010
由上表4和表5可知,本发明试剂盒对测需氧菌性***炎(即AV)的灵敏度为84.38%,特异性为95.56%,符合率(即本发明与革兰氏染色显微镜镜检结果的符合率)为93.87%;本发明试剂盒对细胞溶解性***病(即CV)的灵敏度为87.5%,特异性为98.53%,符合率(即本发明与革兰氏染色显微镜镜检结果的符合率)为98.11%。结果表明,本发明具有较好的特异性和准确率。

Claims (8)

1.一种***炎多联检试剂盒,包括具有多个反应孔的反应板,其特征在于:所述反应孔依次为过氧化氢反应孔、精氨酸氨基肽酶反应孔、凝固酶反应孔、脯氨酸氨基肽酶反应孔、唾液酸苷酶反应孔、乙酰氨基葡萄糖苷酶反应孔、高浓度过氧化氢反应孔、pH反应孔、白细胞酯酶反应孔和葡萄糖苷酶反应孔;
所述过氧化氢反应孔的稳定保护剂为抗坏血酸;
所述高浓度过氧化氢孔的稳定保护剂为焦亚硫酸钠;
所述精氨酸氨基肽酶反应孔的显色底物为含有色原的L-精氨酸单肽底物。
2.根据权利要求1所述的***炎多联检试剂盒,其特征在于:所述抗坏血酸的浓度为5-50mg/L;所述焦亚硫酸钠的浓度为0.03-0.2g/L。
3.根据权利要求1所述的***炎多联检试剂盒,其特征在于:所述含有色原的L-精氨酸单肽底物的浓度为0.2-0.8g/L,溶剂为Tris-柠檬酸缓冲液;所述精氨酸氨基肽酶反应孔的稳定剂保护液为30-50g/L蔗糖。
4.根据权利要求3所述的***炎多联检试剂盒,其特征在于:所述含有色原的L-精氨酸单肽底物为L-精氨酸-β-萘胺盐酸盐。
5.根据权利要求1所述的***炎多联检试剂盒,其特征在于:还包括稀释液和用于终止精氨酸氨基肽酶反应孔、脯氨酸氨基肽酶反应孔和凝固酶反应孔反应的终止液,所述稀释液为含有甘露醇浓度为0.1%~3%的0.9%氯化钠溶液;所述终止液为酸性终止液。
6.根据权利要求5所述的***炎多联检试剂盒,其特征在于:所述酸性终止液为含有0.01%-0.2%4-二甲氨基肉桂醛的盐酸,且所述盐酸的浓度为0.5~2.0M。
7.根据权利要求1所述的***炎多联检试剂盒,其特征在于:所述过氧化氢反应孔包被的反应底物还包括过氧化物酶50-200kU/L、4-氨基安替比林0.3-1g/L,TOOS 1-4g/L,溶剂为PBS缓冲液;
所述高浓度过氧化氢反应孔包被的反应底物还包括过氧化物酶50-200kU/L、4-氨基安替比林0.3-1g/L,TOOS 1-4g/L,溶剂为柠檬酸盐缓冲液。
8.根据权利要求1所述的***炎多联检试剂盒,其特征在于:
所述唾液酸苷酶反应孔的底物反应试剂为含有色原的神经氨酸盐,所述含有色原的神经氨酸盐的配制溶剂是由无水乙醇和柠檬酸盐缓冲液混合而成;
所述葡萄糖苷酶反应孔的底物反应试剂为浓度为含有色原的葡萄糖苷,所述含有色原的葡萄糖苷采用PBS缓冲液配制而成;
所述pH反应孔的底物反应试剂为溴甲酚绿和NaOH;
所述白细胞酯酶反应孔的底物反应试剂为5-溴-4-氯-3-吲哚乙酸盐溶液,其中5-溴-4-氯-3-吲哚乙酸盐溶液的溶剂为甲醇和柠檬酸盐缓冲液混合而成;
唾液酸苷酶反应孔、葡萄糖苷酶反应孔、pH反应孔和白细胞酯酶反应孔的稳定剂保护液均为20-50g/L D-山梨醇水溶液。
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