两种特异抗体检测与B超诊断在包虫病流行病学调查中的应用  

Epidemiological Application of Serology Tests and Its Correlations with Ultrasound Diagnosis of Human Echinococcosis

作　　者：黄菱[1] 李正直[1] 李燕兵[1] 方丽梅[1] 李红卫[1] 袁方[1] 杨玉荣[1] 

机构地区：[1]宁夏医科大学基础医学院病原生物学与免疫学系,银川750004

出　　处：《宁夏医科大学学报》2012年第6期557-560,568,共5页Journal of Ningxia Medical University

基　　金：国家自然科学基金项目(30960339)

摘　　要：目的应用酶联免疫吸附试验(ELISA)和滴金免疫渗滤法(DIGFA)检测人群包虫病流行情况,评价两种抗包虫特异抗体检测结果与B超诊断的一致性,探讨二者在包虫病流调中的应用。方法用粗纯化的人源型细粒棘球蚴囊液抗原(CE抗原)和鼠源型的泡球蚴组织抗原(AE抗原)做常规ELISA,检测-80℃存放8年的1999份滤纸血的包虫病特异性抗体,其结果与流调现场应用的DIGFA法检测结果进行比较,并将两种方法的血清学检查结果分别与现场B超诊断比较。用Kappa一致性检验,确定检查结果的一致性。结果用ELISA法检测-80℃存放8年的血清结果和现场用DIGFA法检测包虫阳性率分别为6.70%(134/1999)、7.15%(143/1999);以≥60岁组为最高(24.44%和17.78%);各年龄组间差异有统计学意义(P均<0.01)。女性感染率(7.96%和9.45%)高于男性(5.58%和5.11%),性别间差异有统计学意义(P均<0.05)。包虫病诊断中ELISA法检测结果敏感性与特异性均高于DIGFA法,与B超诊断结果一致良好(Kappa=0.41);反之亦然,DIGFA检测结果与B超诊断结果不完全一致(Kappa=0.26)。结论包虫病感染率与年龄和性别有关。DIGFA方法操作简单,检查用时短,所需设备简单,适合于流动性现场调查用;而ELISA法用时较长,检查要求有相当的实验室设备和一定培训技能的人员进行操作,用于现场流调有一定困难,但特异性和敏感性相对比前者高,尤其是用较为新鲜的血样标本更为理想。Objective To evaluate the diagnostic correlation of ultrasound with serological tests of enzyme - linked immunosobent Assay （ELISA） and dot immuno - gold filtration assay （DIGFA） in human echinococco- sis. Methods Filter -paper blood samples （n = 1999） from surveyed population in 2002 -2003 after eight year storage at -80℃ were detected by routing ELISA with use of primarily purified native cystic echinococ- cosis antigen （ CE - Ag） of human - origin and alveolar echinococcosis antigen （ AE - Ag） of rodent - origin. The outcomes were compared with the results of DIGFA, which were undertaken in real time surveys. Subse- quently, a comparison of the correlative relationships of the serological outcomes by ELISA ＆ DIGFA tests with ultrasound outcomes that were also generated in real - time surveys. The comparison of relationsip was ana- lyzed by use of KAPPA statistical programme to determine the correlation values. Results The sero - positive rates of serological tests （ ELISA and DIGFA） and the prevalence of ultrasound examination of human echino- coccosis were showed at various levels of 6.70% （134） and 7.15% （143） , respectively amongst surveyed population. The highest infection rates were found at 60 age group （24.44% and 17.78% ） . Infection rates between age groups were significantly different （P 〈 0.01 ）. Female （7.96% and 9.45% ） infection rates were respectively significantly higher than male ones （5.58% and 5.11% ） , P 〈0.05. Compared ultrasound diagnostic outcomes with two serological test outcomes, the sero - test results by use of ELISA method （Kappa = 0.41 ） showed more consistency with ultrasound diagnostic results than the outcomes from sero -test by use of DIGFA method （ Kappa = 0.26） did. Conclusion The human echinococcosis seropostive rates/ prevalence was associated with the sex and age of subjects. ELISA is more sensitive and specificity than DIG- FA approach. Therefore, ELISA/DIGFA has their advantages and disadvantages, respectiv

关 键 词：酶联免疫吸附试验 滴金免疫渗滤法 包虫病诊断 

分 类 号：R532.32[医药卫生—内科学]