中枢神经系统疾病中弓形虫感染的检测研究  

STUDIES ON DETECTING THE INFECTION OF TOXOPLASMA GONDII IN DISEASES OF CENTRAL NERVOUS SYSTEM

作　　者：王昌源[1] 张洪花[1] 时法茂[1] 李玉娥[2] 王世君 

机构地区：[1]山东省寄生虫病防治研究所,济宁272033 [2]济宁市精神病防治院 [3]莱西市卫生防疫站

出　　处：《中国人兽共患病杂志》2001年第3期75-76,79,共3页Chinese Journal of Zoonoses

摘　　要：目的　了解中枢神经系统疾病尤其是脑囊虫病患者中弓形虫感染情况 ,研究弓形虫抗体、抗原检测方法的效果和意义。方法　应用ELISA和IFAT抗体检测方法及单克隆抗体 (4C10、1E9)夹心ELISA抗原检测方法对 2 70例脑囊虫病、15 4例疑似脑囊虫病、88例原发性癫痫患者和 144例健康人群血清进行弓形虫抗体、抗原检测和比较。结果　ELISA和IFAT检测各组人群抗弓形虫抗体阳性率分别为 15 93 %、13 6 4%、12 5 0 %和 6 2 5 % ,14 0 7%、13 6 4%、14 77%和 5 5 6 %。各组弓形虫抗原阳性率分别为 2 2 2 % (6 /2 70 )、3 2 5 % (5 /15 4)、2 2 7% (2 /88)、0 0 0 % (0 /144 )。 13例循环抗原阳性者 ,其抗体滴度为 1∶16 0 0者 1例 ,等于或高于 1∶3 2 0 0者 12例。结论　中枢神经系统疾病尤其是脑囊虫病患者中弓形虫感染率明显高于健康人群 ,提示部分脑囊虫病患者并发或继发了弓形虫感染 ,或脑弓形虫感染误诊为脑囊虫病或原发性癫痫病 ;与IFAT相比 ,ELISA检测抗弓形虫抗体较客观、易于定量 ;当患者血清中抗弓形虫抗体滴度等于或高于 1∶16 0 0时 ,提示有弓形虫现症感染的可能性 ,应进一步进行弓形虫抗原、DNA或其他病原学检查 ;单克隆抗体 (4C10、1E9)夹心ELISA可应用于弓形虫感染的诊断。Aim To understand the status of toxoplasma in fection in cases with the diseases of central nervous system especially with neurocysticercosis and to study the effect and significance of the immunoassays for antigen and antibody of Toxoplasma gondii.Method The antibodies and antigens of Toxoplasma gondii were detected by ELISA and IFAT,and by McAb(4C10/1E9) Sandwich ELISA respectively in the sera of 270 neurocysticercosis cases,154 cases suspected of neurocysticercosis,88 primary epilepsy cases and 144 health people.Results The antibody positive rates of the four groups by ELISA and IFAT were 15.93%,13.64%,12.50% and 6.25%,14.07%,13.64%,14.77% and 5.56% respectively.The antigen positive rates were 2.22%(6/270),3.25%(5/154),2.27%(2/88) and 0.00%(0/144).The antibody titer was 1∶1 600 in 1 case,and 1∶3 200 or above in 12 cases who had a circulationg antigen positive result.Conclusion The infective rate of Toxoplasma gondii in cases with diseases of central nervous system esp.in those with neurocysticercosis was significantly higher than that in health population.Such a result indicated that a small portion of neurocysticercosis cases was accompanied by or followed by toxoplasma infection,and some cerebral toxoplasmosis might be misdiagnosed as neurocysticercosis or primary epilepsy.Compared with IFAT,ELISA was more objective and easy for quantity evaluation.If the titer of antibodies against Toxoplasma gondii in serum of a patient was 1∶1 600 or above,a present toxoplasma infection was indicated,and therefore etiological examinations such as detection of the specific antigens or DNA should be followed.The results of the study proved that McAb Sandwich ELISA was applicable for diagnosis of toxoplasma infection.

关 键 词：脑囊虫病 原发性癫痫 弓形虫感染 IFAT ELISA 单克隆抗体 中枢神经系统 

分 类 号：R531.8[医药卫生—内科学] R741[医药卫生—临床医学]