肺吸虫特异性IgG4快速检测方法的建立与应用  

Development and application of rapid detection in specific IgG4 of paragonimiasis

作　　者：马安[1] 施晓华[1] 王越[1] 干小仙[1] 

机构地区：[1]浙江省医学科学院寄生虫病研究所,杭州310013

出　　处：《中国人兽共患病学报》2010年第4期353-355,共3页Chinese Journal of Zoonoses

基　　金：浙江省自然科学基金项目(M303823);浙江省医药卫生重点科技项目联合资助(2003ZD001)

摘　　要：目的创建简易、快速、准确的肺吸虫病免疫诊断方法。方法用卫氏并殖吸虫成虫粗提液为抗原,以胶体金标记抗人IgG4单抗为检测探针,采用自行设计的垂直流渗滤装置,创建快速检测人血清肺吸虫特异性IgG4方法(P-IgG4-DIGFA),平行检测IgG作比较分析;以经典ELISA为对照,评价其诊断价值,应用P-IgG4-DIGFA检测有效治疗后病人血清,评价其疗效考核价值。结果P-IgG4-DIGFA检测人血清中肺吸虫特异性IgG4的敏感性和特异性分别为95.2%(40/42)、100%(50/50),与血吸虫病患者血清的交叉反应率仅为2%(1/50),未发现与华支睾吸虫病有交叉反应。P-IgG4-DIGFA的敏感性和特异性略高于经典ELISA,差异无统计学意义(χ2=0.25,P>0.05);应用P-IgG4-DIGFA检测有效治疗后3个月、6个月和12个月病人血清特异性IgG4,阴转率分别为0%、16.7%(1/6)和100%。结论金标渗滤法快速检测肺吸虫特异性IgG4,不仅操作简便、快速,而且敏感性高、特异性强,适用于临床检验和现场查病,对治疗后1年病人具有疗效考核价值,有待进一步开发应用。To develop a simple,rapid and sensitive immunoassay for diagnosis of paragonimiasis, crude extract of Paragonimus westermani adult worm was used as antigen and anti-human IgG4 monoclonal antibody （McAb） was conjugated to colloidal gold to work as the detection probe. Vertical-flow filtration assay was designed according to the reaction procedure to detect specific IgG4 or IgG in patients’ sera. ELISA for determination of IgG4 was used as the control test to evaluate the new rapid immunoassay （P-IgG4-DIGFA）. The sensitivity and the specificity of this new rapid immunoassay for specific IgG4 were 95.2%（40/42）and 100%（50/50）,respectively. Cross reaction rate with patient sera of schistosomiasis was 2% （1/50）and none cross reaction with clonorchiasis was showed in this study. Sensitivity and specificity of P-IgG4-DIGFA were slightly higher than that of ELISA, while the differences were not statistically significant according to chi-square criterion （χ2 =0.25,P0.05）. The serum specific IgG4 positive rates were 100%, 83.7% and 0% for post-treatment of 3 months, 6 months and 12 months, respectively. Results showed that this new immunoassay for detection of specific IgG4 was a rapid and simple method with sensitive and specific features. Moreover, it was quite useful for clinical diagnosis and investigation of paragonimiasis.

关 键 词：肺吸虫病 IGG4 金标免疫渗滤法 诊断 

分 类 号：R383.2[医药卫生—医学寄生虫学]