酚糖酯-免疫球蛋白M和鼻分泌物中麻风菌PCR检测在麻风流行病学中的应用  

The detection of PGL-IgM and M. leprae in nasal secretion in the application of leprosy epidemiology

作　　者：翁小满[1] 温艳[1] 袁联潮[1] 杨荣德 龙恒 卢少峰 张远文 洪炳和 王耀辉 赵雪松 郭耀辉 杨光荣 李桓英[1] 

机构地区：[1]北京热带医学研究所,100050 [2]云南省文山州皮肤病防治所 [3]云南省文山州邱北县皮肤病防治站

出　　处：《中国麻风皮肤病杂志》2005年第6期425-428,共4页China Journal of Leprosy and Skin Diseases

基　　金：美国Heiser基金会(1998-2000)

摘　　要：目的通过对流行乡村(同烘和南丘)麻风病患者、家内接触者及普通人群麻风菌感染的检测,评估实验流行病学对预测麻风病传播的意义。方法采用酚糖酯-酶联免疫吸附试验(PGL-ELISA)和检测鼻携带麻风菌的PCR方法,开展流行病学调查。结果(1)麻风病家内接触者的酚糖酯-免疫球蛋白M(PGL-IgM)阳性率和PCR检测的麻风菌鼻携带率分别为30.4%和23.1%;但PGL抗体阳性率在家内接触者和普通村民之间却无显著性差异。(2)两村普通村民的PGL-IgM阳性率,在统计学上无显著差异。然而,在<20岁的年龄组中,同烘村的PGL-IgM阳性率却显著高于南丘村。无论同烘或南丘村,PGL-IgM阳性率高峰均在<20岁的年龄组。随年龄的增加,阳性率逐渐下降。此外,女性的PGL-IgM阳性率高于男性。结论两村的新发现病人主要为年轻人,这与两村PGL-IgM阳性高峰位于<20岁年龄组相关。在<20岁的年龄组中,同烘村的PGL-IgM阳性率显著高于南丘村,除与同烘村患病率和发现率均高于南丘村相关,也与消除麻风病运动(LEC)后,同烘村仍有新病人出现有关。这一现象似乎支持麻风患病率与PGL-IgM阳性率相关。为评价麻风病的传播是否得到控制,以PGL的血清学仍是一种有用的方法。Objective: To evaluate the significance of experimental epidemiology in the transmission of leprosy through detecting the infection with M. Leprae among leprosy patients, household contacts and normal population in leprosy endemic area. Methods: An epidemiological survey was conducted with the detection of PGL-IgM and M. leprae in nasal swab among leprosy patients, household contacts and normal population in leprosy endemic areas-Tonghong and Nanqiu villages, Yunnan Province. Results: (1) In leprosy household contacts, positive PGL-IgM and M. leprae nasal carriage with PCR were 30.4 % and 23.1 % respectively, but there was no significant difference in PGL-IgM positivity rates between household contacts and general villagers in the two villages. (2) No significant difference in PGL-IgM positivity rates can be found in general villagers between the two villages. The peak of PGL-IgM positivity was in the age group of <20 years and the positivity rate decreased as the age increased. However, in the group of <20 years, the positivity rates of PGL-IgM in Tonghong was much higher than those in Nanqiu village. ~Conclusion : Most new cases detected during the leprosy elimination campaigns (LEC) and after LEC were younger and it parallels to the peak of PGL-IgM positivity within the age group of <20 years. The prevalence and detection rates in Tonghong village are higher than those in Nanqiu and they are also associated with higher PGL positivity rate within the age group of <20 years in Tonghong. The phenomenon seems to support that there is correlation between leprosy prevalence and PGL positivity. Laboratory test based on PGL-ELISA is still a useful tool in the evaluation of leprosy transmission.

关 键 词：PCR检测 麻风流行病学 免疫球蛋白M 酚糖酯 鼻分泌物 酶联免疫吸附试验 实验流行病学 流行病学调查 PGL 麻风菌感染 PCR方法 显著性差异 抗体阳性率 IGM阳性 麻风病 年龄组 20岁 接触者 普通人群 患病率 携带率 统计学 

分 类 号：R755[医药卫生—皮肤病学与性病学]