轮状病毒感染是导致5岁以下儿童急性脱水性胃肠炎的主要原因。病毒性胃肠炎与细菌性胃肠炎临床表现相似，须通过实验室检测进行鉴别诊断。不同的检测方法在临床适用的场景不同且存在一定的局限性。传统的形态学、免疫学检测方法正逐步被高特异性、高敏感性的分子诊断技术所替代。以经典的酶联免疫吸附试验(enzyme linked immunosorbent assay，ELISA)和聚合酶链反应(polymerase chain reaction，PCR)作为基础，分别发展出来的胶体金免疫层析法(gold immunochromatography assay，GICA)和实时反转录聚合酶链反应(real time reverse transcription PCR, real time RT-PCR)已在临床上有着广泛的应用。但是GICA敏感性不足，无法检测出感染初期病毒表面的抗原；RT-PCR法耗时较长，无法提供及时的诊断。不断发展的基因检测技术拥有更广泛的使用前景，如环介导等温扩增检测(loop mediated isothermal amplification，LAMP)、基因芯片、二代测序等，可以在高特异性、高敏感性的前提下更快速地提供有价值的诊断报告，与此同时亦可为病毒流行病学提供数据支持。此外，许多已经运用于其他病毒检测的新技术如肽核酸(peptide nucleic acid，PNA)、NASBA-CRISPR裂解法、适配子等可以特异性扩增病毒RNA序列，具有低成本、高效率的特点，可望改进后运用于轮状病毒实验室诊断。本文主要针对轮状病毒实验室诊断方法的临床应用、优缺点及检测的最新技术展开综述。
Rotavirus infection is the leading cause of acute dehydrated gastroenteritis among children under 5 years old worldwide. Nonetheless, viral gastroenteritis is often difficult to differentiate from gastroenteritis caused by enteric bacteria on the basis of clinical presentation. Therefore, laboratory tests are required for adequate specific diagnosis. Therefore, laboratory tests are required for adequate specific diagnosis. Different detecting methods suit for different situations. Traditional morphological and immunological methods are substituted by molecular diagnostic method, which have high specificity and sensibility. The enzyme-linked immunosorbent (ELISA) and polymerase chain reaction (PCR) are the basic assays that provide the platform for development of several efficient diagnostics such as gold immunochromatographic Assay(GICA) and real time RT-PCR have already used in diagnosing rotavirus. However, the sensibility of GICA cannot support itself for detecting low concentrations of antigen. For RT-PCR, it takes too long to diagnose rotavirus. Loop-mediated isothermal amplification (LAMP), microarrays and next generation sequencing. Furthermore, several diagnostics for other virus might be applied to Rotavirus diagnosis such as Peptide nucleic acid(PNA), NASBA-CRISPR cleavage, Aptamers, these diagnostics can amplify fragments of virus specifically and make the detection cheaper and quicker. In this article, we review the methods and advanced technologies of rotavirus detection.
