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迅速検査法による鼻の粘液を使ったインフルエンザの検査

笑顔医師

インフルエンザの疑いがある場合には、すぐに病院にいく必要があります。
インフルエンザの特効薬は、リレンザ、タミフル等がありますが、これらの薬は発症後48時間以内に摂取しないと効果がないとされています。

インフルエンザが疑われる時には、医療機関では簡易検査キットによる迅速検査法がとられます。もっと精度の高い検査方法もありますが、すばやく検査ができるこの方法は多くの病院や医療機関で広くとられているのです。

インフルエンザの特効薬を使えるようにこの検査方法をとるのですが、しかしながら鼻の粘膜からそれを摂取するため綿棒をグリグリ入れられてしまいます。

このような鼻の粘液を使ったインフルエンザの検査方法は必要なのでしょうか。本記事では、インフルエンザ検査を鼻の粘膜からとるその理由についてお話いたします。 

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インフルエンザウイルスと鼻の粘膜

鼻子供

インフルエンザウイルスと鼻の粘膜との関係について書きます。インフルエンザウイルスは、鼻の粘膜、特に上咽頭(鼻の奥)に密着することが多いのです。これは、扁桃や喉や口の中などからすりとるよりも高い精度で検出できるため、簡易検査キットを使った迅速検査法では鼻を使うことが非常に多いということなのです。

簡易検査キット

簡易検査キットは、非常に小さな検査キットです。大型の分析装置をつかった検査には劣りますが、10分から15分程度で出るとされています。陽性反応の場合はもっと早く出ます。どこの病院でも、あるいは診療所でも常備されています。

簡易キットでは、ペーパークロマトグラフィーによってウイルスの有無を判別します。本来は透明で目に見えないはずのウイルスに、赤い色をつけて一箇所にあつめることで目指できるようにするという仕掛けです。

しかしながら、この方法ではある程度の量のウイルスがいないと色を変えることができません。しばしば陽性であるにも関わらず見逃してしまうという偽陽性が起きてしまいます。この擬陽性率が簡易キットでは少なくなく、陰性の場合でも2度にわたって検査を擦ることがあります。

特に、罹患後12時間以内ではウイルスの数も少なく、擬陽性率が大幅に上昇することが知られています。擬陽性率を下げるために、2度の検査を行うというわけです。

鼻検査の問題点

鼻の粘膜から粘液を摂取して検査キットにかけるという検査方法は、結果がすぐにでるうえ、どこでも容易に検査が可能な点、非常に高い利便性があります。他にも様々な検査方法があるのですが、この2つを兼ね備えている検査方法はあまりありません。

ところが、鼻の粘膜をかなり強くこすらなければならないうえ、鼻の奥にあるため、非常に困難が伴う場合もあるのです。鼻の粘膜を摂取するためには、綿棒などを奥までツッコまなければなりません。

大人であれば辛抱できますが、子供ではけっこうたいへんです。子供が鼻に棒を突っ込まれることを嫌って暴れてしまったりして、鼻の粘膜を傷つけて鼻血がでることも少なくありません。喉の奥などをこすって検査をする方法もありますが、これがきっかけで検査が嫌いになってしまう子供も多数いるそうです。

新しい検査方法

大型の分析装置を使ったインフルエンザ検査も普及しつつあります。そこではフィルム現像の技術が応用されており、僅かな量のウイルス大型化させて確認することで、的確に検出することができます。目で見てウイルスの有無を判明させる簡易キットではなく、電子的に有無を確認することができるので精度も大幅に向上しています。

この検査は以前は長時間の現像時間がかかりましたが、現在では一日以内に確認することができるようになるなど、素早い検査が可能になりました。この検査方法では、鼻水などの粘液でも十分な検出が可能です。

子供にもやさしい検査方法

鼻の奥の粘膜をとるのではなく、鼻をかむことで粘膜を取得する鼻かみ検査キットを使う病院も増えてきました。子供も簡単に検査ができますし、痛い思いをしないですみます。

また、鼻かみができない小さな子供でも吸入管を使って鼻の粘液を摂取することができます。これらは小児科の病院や、子供向けのサービスが充実している耳鼻咽頭科などでも受けることができます。

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まとめ:インフルエンザの検査は鼻からが基本

インフルエンザの検査は鼻の粘膜を調べるのが基本です。基本的には綿棒などでこすって手に入れますが、これだと痛みを感じてしまったり、つらい思いをしたりすることもあります。子供が嫌がるのもむべなるかなといったところでしょうか。

最近では、鼻水や鼻かみなどでも十分な検査ができる検査方法も開発されています。子供であったり、鼻が敏感な方、鼻炎がひどい場合などは別の方法がとれないか医者に相談してみましょう。

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