ELISA与IHA在血吸虫病不同流行程度地区的现场筛查效果评价  

Evaluation of screening effects of ELISA and IHA techniques in different epidemic areas of schistosomiasis

作　　者：汪奇志[1] 汪峰峰[1] 尹晓梅[1] 朱磊[1] 张功华[1] 方国仁[1] 汪天平[1] 肖祥[1] 姜庆五[2] 

机构地区：[1]安徽省血吸虫病防治研究所,安徽省血吸虫病重点实验室,芜湖市241000 [2]复旦大学公共卫生学院流行病学教研室

出　　处：《热带病与寄生虫学》2006年第3期135-139,共5页Journal of Tropical Diseases and Parasitology

基　　金：国家十五科技攻关计划项目(2004BA718B05);安徽省"十五"二期传染病综合防治研究专项(040130326)

摘　　要：目的评价与比较ELISA法和IHA法在血吸虫病不同流行程度地区的筛查效果。方法选择四个日本血吸虫病流行程度不同的试点村,对5～65岁适检人群进行Kato-Katz法(二送三检)、ELISA法、IHA法等3种方法平行检测。结果ELISA法的敏感度和特异度分别为96.05%、95.74%,IHA分别为89.74%、100%。但两种方法现场“特异度”较低(ELISA:43.21%￣92.17%;IHA:67.56%～91.55%),且其阳性预测值亦较低(ELISA法:3.1%￣18.6%;IHA:2.9%￣15.8%)。两法平行检测比较:两者的测定值具有一定的相关性(r=0.767,P<0.01),但IHA法阳性阈值(1∶10)对应的OD值高于ELISA阳性阈值水平(0.105),在0.124￣0.308左右。在疫情相对较重的地区,ELISA法阳性率高于IHA,其阳性预测值低于IHA;在疫情相对轻的地区,两法阳性率、阳性预测值无显著性差异。结论在血吸虫病疫情未控制地区,IHA法现场筛查效果相对优于ELISA法,但两者均存在假阳性率较高、阳性预测值较低的缺陷。　Objective To evaluate and compare the screening effects of ELISA and IHA techniques in different epidemic areas of schistosomiasis japanica. Methods Four villages,with different epidemicity of schistosomiasis,were selected as fields, of which every subject was examined with kato-katz, ELISA and IHA techniques simultaneously. Results The sensitivity and specificity of ELISA and IHA were very high （ELISA： 94.87%, 95.74%; IHA：89.74%,100%） . But the field-based detection indicated that the specificity of two serological techniques was relatively low （ELISA：43.21%~92.17%;IHA：67.56%～91.55%）, and the PPV were remarkly low as well（ELISA：3.1%~18.6%;IHA：2.9%~15.8%）. The result of the parallel detection showed that the detection values between ELISA and IHA were significantly correlating（r=0.767,P〈0.01）, but the corresponding OD （optical density） value of the threshold value of IHA （1：10）, about 0.124~0.308, was higher than the threshold of ELISA （0.105）. The positive predictive value （PPV） as well as positive rate of IHA was significantly higher than ones of ELISA in the higher endemicity villages, and no significant difference with ELISA in the lower endemicity villages. Conclusion In an endemic area of schistosomiasis, the screening effects of IHA relatively outweigh ELISA, but there was a common drawback for two serological techniques, that is, the PPV were quite low in field investigation.

关 键 词：日本血吸虫病 酶联免疫吸附试验 间接血球凝集试验 KATO-KATZ法 

分 类 号：R512.62[医药卫生—内科学]