血吸虫循环抗原检测在血吸虫病普查中的应用  

Evaluation of ScAg Detection in Different Endemic Levels and Compared with Fecal Examination

作　　者：许成华[1] 周建明[1] 毛中贵[1] 

机构地区：[1]夹江县疾病预防控制中心,四川夹江614100

出　　处：《寄生虫病与感染性疾病》2005年第4期165-167,共3页Parasitoses and Infectious Diseases

摘　　要：目的了解血吸虫循环抗原(ScAg)检测在普查中的应用效果,发挥ScAg检测在血吸虫病传播阻断中的作用。方法在现场单盲试验普查条件下测试血吸虫病血清库质控血清,应用ScAg在不同程度感染的血吸虫病流行区批量检测。对ScAg阳性者作9送9检粪孵追踪观察。结果ScAg检测EPG≤8的血吸虫病患者血清阳性率为95.45%,EPG≥16的血吸虫病患者血清阳性为100.00%,对正常人和华支睾吸虫病患者血清的特异性为100.00%。对高、中、低流行区普查ScAg的阳性率分别为7.27%、3.06%、2.70%。对ScAg阳性的病例粪孵9送9检累计阳性率为34.29%,粪检累计总阳性数中,第1次只检出16.67%,连续第3次的累计阳性率仅为50.00%。连续化疗地区ScAg检测阳性的粪孵阳性率为12.50%,间歇性选择化疗地区ScAg阳性者的粪孵阳性率占75.00%以上。结论9送9检粪孵累计阳性结果显示,检出率随粪检次数增加而升高,粪检漏检多、工作量大、不能正确反映当地疫情。ScAg检测是一种敏感性高,特异性好的简便快速方法,普查结果能反映不同感染度流行地区的实际状况,有利于制定防治策略,了解防治后成效。Objective To evaluate the ScAg （schistosome circulating antigen） detection method in different endemic levels and compared with 9 times of fecal examination so as to confirm its application in schistosomiasis control program. Method StAg detection method was used to test the known sera in sera-bank first, then it was applied in different endemic areas, and compared with 9 times of different samples of fecal examination. Result The positive rate of the sera samples collected from schistosomiasis cases with EPG≤8 was 95.45%, while it was 100% in those with EPG≥16. The specificity of ScAg detection of the sera from normal individuals and clonorchiasis cases reached 100%. The ScAg positive rates in hyper-, meso-, and hypo-endemic areas were 7.27%, 3.06% and 2. 70% respectively. The accumulative positive rate of fecal examination with 9 times of different samples was 34. 29% in which 16. 67% were positive in first fecal examination, and it was only 50% after three times of fecal examination. In area with continuous chemotherapy activities, the positive rate of fecal examination in ScAg positives was 12.50%, while it was over 75% in area with intermittent chemotherapy activities. Conclusion The results showed that fecal examination couldn＇t reflect the real endemic levels. Besides, it had large work load and higher misdiagnosis rate. ScAg detection was a diagnosis method with higher specificity and sensitivity and when it was applied in mass screening, the result could reflect the real endemicity.

关 键 词：血吸虫循环抗原 诊断 普查 

分 类 号：R532.21[医药卫生—内科学]