抗烟曲霉果胶裂解酶A抗体检测对侵袭性曲霉病诊断价值的评估  

Evaluation of Diagnostic Value of Antibody Against Aspergillus Fumigatus Pectate Lyase A for Invasive Aspergillosis

作　　者：商秀娟[1,2] 张国勇[2] 刘倩[2] 陈笑[2] 李芳秋[2] 

机构地区：[1]江苏大学医学院,江苏镇江212013 [2]南京军区南京总医院解放军检验医学研究所中心实验科,南京210002

出　　处：《现代检验医学杂志》2016年第1期5-7,11,共4页Journal of Modern Laboratory Medicine

基　　金：国家自然科学基金资助项目（81302536）,南京军区医学科技创新重点课题（102027）.

摘　　要：目的建立检测抗烟曲霉果胶酶A（pectate lyase A，PlyA）抗体的ELISA方法，评估其对侵袭性曲霉病（invasive aspergillosis，IA）的诊断价值。方法用重组PlyA作为包被抗原，建立检测人抗PlyA IgG抗体的间接ELISA方法。检测97例IA患者、80例非IA患者和200例体检健康者血清。将所得结果与抗烟曲霉硫氧还蛋白还原酶（thioredoxin reductase，TR）抗体和抗烟曲霉二肽基肽酶V（dipeptidyl peptidase V fragment,DPPV）抗体结果比较。结果抗PIyA IgG抗体ELISA方法的批内变异系数为5．3％，批间变异系数为10．9％。诊断IA的敏感度为62．9％，特异度为90．4％。非中性粒细胞缺乏IA患者和中性粒细胞缺乏组患者阳性率分别为72．3％和43．8％（χ^2=7．493，P〈0．05）。抗PlyA，抗TR，抗DPPV抗体检测的阳性率分别为62．9％，60．8％和66．0％，三者差异无统计学意义（χ^2=0．562，P〉0．05）；三种方法联合检测的阳性率可达到92．8％。结论成功建立了检测抗PlyA IgG的ELISA方法；抗体检测对非粒细胞减少IA患者的诊断价值均优于粒细胞减少IA患者；联合三种抗体检测可提高诊断敏感度。Objective To establish an ELISA for detecting antibody against Aspergillus fumigatus pectate lyase A（anti- PIyA） ,and evaluate its diagnostic value for invasive aspergillosis （IA）. Methods An indirect ELISA for IgG antibody a- gainst PlyA was established using PlyA as coating antigen. The serum from 97 IA patients, 80 non-IA patients and 200 healthy donors were tested,the results were compared with anti-DPPV （antibody against Aspergillus fumigatus dipeptidyl peptidase V fragment） and anti-TR （antibody against Aspergillus fumigatus thioredoxin reductase）. Results The intra-assay coefficients of variation of the EIASA method for detecting anti-PlyA was 5.3 % ,and inter-assay coefficients of variation was 10.9 %. The sensitivity and specificity of diagnosis of IA were 62.9 % and 90.4 % ,respectively. The positive rates of anti-PlyA in non-neutropenic and neutropenic IA patients were 43.8% and 72.3 %, respectively （χ^2= 7. 493 ,P〈0. 05）. There was no significant difference between the positive rates of anti-PlyA （62.9%） ,anti-TR （60. 8%） ,and anti-DPPV （67.0%） （χ^2=0. 562, P〉0.05）. When combined anti-PlyA, anti-TR,and anti-DPPV, the diagnostic sensitivity for IA patients increased to 92.8%. Conclusion An ELISA for detecting anti-PlyA was successfully established. The diagnostic value of these three kinds of antibody was superior in non-neutropenic IA patientsto that in neutropenic IA patients. The comhined detection of three antibodies could provide higher sensitivity.

关 键 词：烟曲霉 果胶裂解酶A IGG抗体 ELISA 

分 类 号：R379[医药卫生—病原生物学] R392.11[医药卫生—基础医学]