湖沼型流行区常用血吸虫病查病模式效能分析  

Efficacy of routinely used patterns for schistosomiasis diagnosis in lake and marshland regions

作　　者：张瑕[1] 崔彩霞[1] 张维荣[1] 文晓红[1] 马念[1] 邹萍[1] 涂祖武 胡合华 刘雄[1] 曹淳力[3] 许静[3] 

机构地区：[1]湖北省江陵县血吸虫病防治所,中国疾病预防控制中心寄生虫病预防控制所湖沼型血吸虫病防治科研基地,江陵434100 [2]湖北省血吸虫病防治所 [3]中国疾病预防控制中心寄生虫病预防控制所,卫生部寄生虫病原与媒介生物学重点实验室,世界卫生组织疟疾,血吸虫病和丝虫病合作中心

出　　处：《中国血吸虫病防治杂志》2014年第6期618-621,共4页Chinese Journal of Schistosomiasis Control

基　　金：湖北省荆州市医药卫生科技计划项目(20121PE1-1);湖北省荆州市2013年医药卫生科技计划项目(20131PE1-1)

摘　　要：目的评价湖沼型流行区常用血吸虫病查病模式效能。方法选择江陵县荆干村作为调查点,采集6-65岁常住居民静脉血,采用间接血凝试验（IHA）、胶体染料试纸条法（DDIA）进行平行检测,对任一方法检测阳性者采用KatoKatz法、尼龙绢集卵孵化法进行平行检测。对两种免疫学方法的一致性进行评价,并分别以IHA、DDIA、IHA＋DDIA法筛查再加病原学检测3种查病模式来推算受检人群的感染率。结果血清学方法共检测530人,DDIA、IHA的抗体阳性率分别为46.98%（249/530）、28.49%（151/530）,前者显著高于后者（χ2=59.55,P〈0.01）。两种方法共检出抗体阳性者279人,其中252人接受了病原学检测,Kato-Katz法和集卵孵化法共检出血吸虫感染者22例,IHA、DDIA分别漏检7例和3例。IHA、DDIA、IHA＋DDIA法筛查再加病原学检测3种查病模式对530例受检人群的推算感染率分别是3.14%、3.97%、4.60%。结论在疫情持续降低的情况下,当前常用的血吸虫病查病模式易导致漏诊,应开发更敏感和有效的诊断方法,并探索适合低度流行态势下的血吸虫病筛查新模式。Objective To evaluate the efficacy of routinely used pattern for schistosomiasis diagnosis in lake and marshland regions. Methods A historically heavy endemic village of schistosomiasis named Jinggan Village from Jiangling County was se- lected for field survey. The residents aged 6-65 years were screened by indirect hemagglutination assay （IHA） and dipstick dye immunoassay （DDIA） in parallel. The serological positives were examined by Kato-Katz technique and miracidium hatching technique to determine the infection of schistosome. The consistency of the two serological methods was evaluated. In addition, the schistosome infection rates were estimated according to the 3 detection patterns namely I.HA, DDIA, IHA＋DDIA combined with the etiologic examination. Results A total of 530 individuals were examined by the serological tests. The positive rate of DDIA was 46.98% （249/530）, significantly higher than that of IHA（28.49%, 151/530） （ X^2 = 59.55, P 〈 0.01 ）. Totally 279 individuals were serological positives determined by IHA or DDIA, while 252 of them were detected by stool examination, and 22 cases were determined as parasitologieal positives, while 7 and 3 cases were diagnosed as antibody negatives by IHA and DDIA, respectively. The estimated infection rates determined by IH＇A, DDIA, IHA plus DDIA combined with stool examination were 3.14%, 3.97%, 4.60%, respectively. Conclusions Under the condition of endemic situation becoming more and more waning, the current routinely used pattern for schistosomiasis detection may lead to missed diagnosis. So, more sensitive and effective diagnostic tools or appropriate detection patterns need to be explored.

关 键 词：日本血吸虫病 病原学检测 免疫学检测 查病模式 效能 湖沼型地区 

分 类 号：R532.21[医药卫生—内科学]