血吸虫循环抗原检测与病原学诊断方法的比较研究  

Comparison Study of Schistosome Circulating Antigen Assay with Aetiological Diagnosis Methods

作　　者：曹昌志[1] 王秀珍[1] 吴庆[1] 沙开友[2] 赵联国 尹洪智[2] 黎世涛[1] 

机构地区：[1]四川省疾病预防控制中心,四川成都610041 [2]西昌市血吸虫病防治站,四川西昌615000

出　　处：《寄生虫病与感染性疾病》2005年第3期97-100,共4页Parasitoses and Infectious Diseases

基　　金：国家高技术研究发展专项经费资助(编号:2004AA2Z3580)

摘　　要：目的观察比较血吸虫循环抗原与病原学诊断方法的应用效果,为经过周期性群体化疗后的血防工作提供有价值的诊断方法。方法用检测血吸虫循环抗原(ScAg)标准化试剂、尼龙绢集卵孵化法、Kato-Katz法平行检测血吸虫病流行区居民感染情况。结果以粪便检查阳性的血吸虫病患者例数为金标准,ScAg的阳性检出率为95.2%(119/125),集卵孵化法阳性率为81.6%(102/125),Kato-Katz法阳性率为65.6%,(82/125)。粪检总阳性中集卵孵化法漏检率为18.4%(23/125),Kato-Katz法漏检率为34.4%(43/125)。ScAg检测与Kato-Katz法检测结果比较差异有统计学意义(χ2=34.750,P<0.01),与集卵孵化法检测结果比较差异有统计学意义(χ2=11.273,P<0.01)。Kato-Katz法中单片阳性占41.5%,二片以上为阳性者占58.5%。ScAg检测分别采用20μl,50μl,100μl三种不同血清样本量进行比较,检出率分别为84.8%(106/125),95.2%(119/125),96.0%(120/125)。结论三种方法中Kato-Katz法检出率最低,虫卵片数分布有很大的机缘性,只适宜研究时作定量用。集卵孵化法中有较多的未成熟虫卵不能孵化,但适宜与镜检虫卵配合应用。ScAg检测符合率高,简便快速,可将46.6%(109/234)粪检漏检者查出,有利于及时治疗,并切断传染源。Objective To compare the diagnostic effect of ScAg assay, collective egg incubation and Kato-Katz methods so as to provide effective diagnostic method after periodic mass treatment. Method Schistosomiasis cases with positive stool examination from hyper-endemic area were selected as diagnostic objects. ScAg assay with standard agent, egg incubation and Kato-Katz methods were conducted and compared in parallel. Result The positive rates were 95.2% （119/125）of ScAg assay,81.6% （102/125） of egg incubation method, and 65.6% （82/125） of Kato-Katz method. The misdiagnostic rates were 18.4% （23/125） of egg incubation and 34. 4% （43/125） of Kato-Katz method. There were significant differences between ScAg and Kato-Katz （X2 =34. 750, P 〈 0.01 ） or egg incubation （X2 = 11. 273, P 〈 0.01 ）. In Kato-Katz method, the positive rates were 41.5% of one slide, and 58.5% of two and three slides. In ScAg assay, different quantities of serum samples were compared and the positive rates were 84. 8% （106/125） of 20 μl,95.2% of 50 μl and 96. 0% （120/125） of 100 μl samples. Conclusion Restricted by egg number and distribution state in stool,the positive rate of Kato-Katz method was the lowest of the three methods. Therefore,the Kato-Katz method was only suitable for quantitative analysis in research program. Because of unmature eggs in the stool, the egg incubation method might be applied as a coordinating method with other egg detecting test. ScAg assay showed higher diagnostic accordance rate and the result showed that ScAg assay could detect out 46.6% （109/234） of positives which missed by Kato-Katz and egg incubation methods. Besides ,ScAg assay was simple and easy to be operated. The authors suggested that ScAg assay would be an effective diagnostic assay for evaluating the therapeutic effect and disease control.

关 键 词：日本血吸虫 循环抗原 病原学 诊断 比较 

分 类 号：R532.21[医药卫生—内科学]