TR/Patoc-Ⅰ株抗原肉眼凝集试验在钩端螺旋体病中的临床意义  

Clinical Significance of Quick Slide Agglutination Test in Leptospirosis

作　　者：严智先[1] 莫伟雄[1] 葛德珊[1] 

机构地区：[1]广东省肇庆市第一人民医院儿科,肇庆526021

出　　处：《热带医学杂志》2005年第2期188-192,共5页Journal of Tropical Medicine

摘　　要：目的探讨血清学TR/Patoc-Ⅰ株抗原的肉眼凝集试验(即快速玻片凝集反应)在钩端螺旋体病中的应用价值。方法对本院1995年7月～2004年5月收治的32例小儿病人进行临床综合分析。血清学检测采用快速玻片凝集反应,并与活抗原显微镜凝集试验相对照。结果快速玻片凝集反应全部阳性。+～++的16例双份血清3～4周后复查增高++以上的有13例。+++～++++的10例3～4周后降为+～++。双份血清升高或降低++以上的有27例,无变化的5例临床诊断均为闭塞性脑动脉炎。入院后1周内SAT和MAT二者敏感度经统计学卡方检验,统计学上有显著差异(P<0.01)。入院1周内SAT+以上的有32例,MAT抗体滴度1∶100以上的有24例,两者阳性率经卡方检测,统计学上有显著差异(P<0.01)。100例非钩体病儿童检验二者的特异性,经卡方检测,统计学上有显著差异(P<0.01)。32例成对标本中,入院后3～4周32例SAT与MAT均阳性,同时阴性为0例。入院后3～4周SAT与MAT一致率为100%。两者结果有一致性(P<0.01)。结论快速玻片凝集反应操作简便、快速、无传染性,并且准确、特异和敏感,对钩体病早期诊断有一定的价值,值得基层医院推广。Objective To investigate and evaluate the appl ication of quick slide agglutinatio n test(SAT)in leptospirosis.Methods 32cases of leptospirosis treated fr om July 1995to May 2004in our hospita l were analyzed.The SAT was performed in the serology test.Microscopic agglutination test(MAT)was chosen as control.Results All patients were positive resuts in the SAT.The c ases with +～++in 16/32reached +++～++++after 3～4weeks in 13/16.The cases with +++～++++in 10/32r educed to +～++after 3～4weeks.It is n ot changed in 5/32of Occlusire cerebral arteritis.Sensitivity of between SAT and MAT were 90.6%and 25%in first 1～2weeks in the hospital respectively(P<0.01).Positive rate of SAT(>+)and MAT(>1∶100)were 100%and 75%in first 1～2weeks in the hospital respectively(P<0.01).Specificity of SAT and MAT were 99%a nd 91%respectively(P<0.01).Of 32patients in the patient group we re diagnosed by SAT and MAT in first 3～4weeks in the hospital .32were posit ive for both SAT and MAT.After hospitali zed for 3to 4weeks,the positive rate s for both SAT ans MAT diagnosis were100%and agree with each other(P<0.01).Conclusions The results suggested this SAT is a simple,rapid,not infectious,accurate,specific and sensitive diagnosis method,and hav e an obvious value during the early di agnosis of the leptospira patients.It is good d iagnosis method for the primary hosp ital.

关 键 词：钩端螺旋体病 血清学试验 抗原 凝集反应 

分 类 号：R514.4[医药卫生—内科学]