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目的:比较免疫功能正常的成年社区获得性肺炎(CAP)患者鼻咽拭子(NPS)和支气管肺泡灌洗液(BALF)病毒核酸检测结果的差异，为病毒性肺炎的诊断提供帮助。方法:本研究为前瞻性研究。选取2019年6月至2020年1月在上海健康医学院附属嘉定区中心医院经常规治疗症状无明显缓解或可疑为病毒性CAP患者121例，采集患者NPS及BALF，采用基因双扩增技术对二者进行病毒核酸检测。结果:入组患者中，除外肿瘤、结核，共有105例CAP患者。其中，BALF阳性17例，包括甲型流感病毒9例(7例H1N1、2例H3N2)、腺病毒4例、副流感病毒2例(均为副流感3型)、呼吸道合胞病毒2例。NPS阳性9例，包括5例H1N1、1例H3N2、2例副流感病毒、1例腺病毒。其中NPS阳性而BALF阴性4例，BALF阳性而NPS阴性12例，两者均阳性5例。BALF和NPS病毒检测阳性率分别为16.2%(17/105)和8.6%(9/105)，两者比较差异有统计学意义(n χ2＝4.32，n P<0.05)。n 结论:对免疫功能正常的成年CAP患者，NPS对病毒检测的阳性率低于BALF，单纯依靠NPS对病毒性CAP的诊断意义有限，应通过自主排痰、诱导痰、BALF等多种标本提高诊断的准确性。“,”Objective:To analyze the difference in viral nucleic acid test results between nasopharyngeal swab (NPS) and bronchoalveolar lavage fluid (BALF) specimens of viral community acquired pneumonia (CAP) patients with normal immune function, helping for the diagnosis of viral CAP.Methods:In this prospective study, 121 CAP patients were enrolled, whose condition did not improved after regular treatment or who were suspected with viral CAP patients in Affiliated Central Hospital of Jiading District, Shanghai University of Medicine & Health Sciences from June 2019 to January 2020.All patients′ NPS and BALF were collected on the same day, both two specimens were tested by the gene double amplification technology.Results:Among the enrolled patients, the cases of tumors or tuberculosis were excluded.There were finally 105 cases of CAP, of whom BALF viral test of 17 cases was positive, including nine cases of influenza A (seven cases of H1N1, two cases of H3N2), four cases of adenovirus, two cases of parainfluenza virus (both were parainfluenza type 3) and two cases of respiratory syncytial virus.The viral test was positive in NPS of nine cases, including five cases of H1N1, one case of H3N2, two cases of parainfluenza virus, and one case of adenovirus.Among them, NPS was positive but BALF was negative in four cases, and BALF was positive but NPS was negative in 12 cases.In five patients, viruses were detected in BALF and NPS samples.The positive rates of BALF and NPS were 16.2%(17/105) and 8.6%(9/105). The difference between the two methods was statistically significant (n χ2=4.32, n P<0.05).n Conclusions:For adult patients with normal immune function who are diagnosed with CAP, the positive rate of NPS for virus detection is lower than that of BALF.The diagnostic significance of viral CAP by NPS alone is limited.The accuracy of diagnosis can be improved by the induced sputum, active expectoration sputum, BALF and any other specimens.