IFA、ELISA和WB用于莱姆病血清学诊断的比较研究  

Serologic diagnosis of Lyme disease with indirect immunofluorescence assay,enzyme-linked immunosorbent assay and western blot

作　　者：刘志云[1,2] 侯学霞[2] 霍秋波 耿震[2] 刘劼[2] 万康林[2] 郝琴[2] 

机构地区：[1]南华大学病原生物所,湖南衡阳421001 [2]中国疾病预防控制中心传染病预防控制所传染病预防控制国家重点实验室,北京102206 [3]黑龙江省牡丹江林业中心医院

出　　处：《中国媒介生物学及控制杂志》2011年第3期236-238,共3页Chinese Journal of Vector Biology and Control

基　　金：国家"十一五"科技重大专项课题(2008ZX10004-010)~~

摘　　要：目的比较研究间接免疫荧光试验(IFA)、酶联免疫吸附试验(ELISA)和蛋白免疫印迹试验(WB)3种检测方法对莱姆病血清学的诊断效果。方法收集临床疑似莱姆病患者血清标本及其流行病学和临床资料,分别采用IFA、ELISA和WB进行血清抗伯氏疏螺旋体抗体(IgM和IgG)检测,结合流行病学和临床资料进行综合分析。结果实验共检测莱姆病疑似患者血清398份,ELISA阳性86例,阳性率21.61%,其中IgM阳性27例,IgG阳性59例;IFA阳性82例,阳性率20.60%,其中IgM阳性26例,IgG阳性56例;WB阳性83例,阳性率20.85%,其中IgM阳性31例,IgG阳性52例;并且实验表明,在对于游走性红斑病例的诊断上,WB法阳性率明显高于ELISA和IFA(χ2=6.34,P<0.05)。结论在莱姆病的实验室诊断中,IFA、ELISA和WB3种方法结合运用,可提高诊断的灵敏性和特异性;WB在排除ELISA和IFA的假阳性结果中有着重要作用。Objective To compare the effectiveness of indirect immunfluorescence assay（IFA） ,enzyme-linked immunosorbent assay（ELISA） and western blot（WB） in serologic diagnosis of Lyme disease. Methods Serum samples,epidemiological data and clinical information of potential Lyme disease patients were collected. Serum antibodies（IgM,IgG） against Borrelia burgdorferi were detected by IFA,ELISA and WB. Results were interpreted based on clinical manifestations and epidemiological data. Results Of the 398 serum samples collected from suspected patients,86 were ELISA-positive（21.61%） ,including 27 IgM positives and 59 IgG positives;82 were IFA-positive（20.60%） ,including 26 IgM positives and 56 IgG positives;and 83 were WB-positive（20.85%） ,including 31 IgM positives and 52 IgG positives. The positive rate of WB for the diagnosis of patients with erythema migrans（EM） was significantly higher than that of ELISA and IFA（χ2=6.34,P〈0.05） . Conclusion The combination of IFA,ELISA and WB may improve the sensitivity and specificity of the laboratory diagnosis of Lyme disease. WB has a lower false positive rate than ELISA and IFA.

关 键 词：莱姆病 伯氏疏螺旋体抗体 酶联免疫吸附试验 间接免疫荧光试验 蛋白免疫印迹试验 

分 类 号：R377[医药卫生—病原生物学]