广西146例华支睾吸虫疑似感染者粪样虫卵和血清IgG抗体的检测分析  

Detection and analysis of fecal egg and serum IgG antibody in 146suspected cases of Clonorchis sinensis infection in Guangxi

作　　者：曾雪梅[1] 蒋智华[1] 申继清[2] 杨庆利 ZENG Xue-mei;JIANG Zhi-hua;SHEN Ji-qing;YANG Qing-li(Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control,Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis,Nanning 530028,China;Department of Parasitology,Guangxi Medical University,Nanning 530021,China;Guangxi University of Chinese Medicine,Guangxi Key Laboratory of Translational Medicine for Treating High-Incidence Infectious Diseases with Integrative Medicine,Nanning 530200,China)

机构地区：[1]广西壮族自治区疾病预防控制中心,广西病毒性肝炎防治研究重点实验室,南宁530028 [2]广西医科大学寄生虫学教研室,南宁530021 [3]广西中医药大学,广西高发传染病中西医结合转化医学重点实验室,南宁530200

出　　处：《中国寄生虫学与寄生虫病杂志》2019年第6期730-732,共3页Chinese Journal of Parasitology and Parasitic Diseases

摘　　要：检测广西华支睾吸虫疑似感染者粪样华支睾吸虫/扇棘单睾吸虫虫卵和血清华支睾吸虫IgG抗体,分析二者的相关性,为华支睾吸虫感染的监测和诊断提供参考。收集2017年3-9月于广西疾病预防控制中心预防性健康体检科就诊的疑似华支睾吸虫感染者粪样,采用改良加藤厚涂片法(一粪三检)检查华支睾吸虫/扇棘单睾吸虫虫卵并计算每克粪样虫卵数(EPG)。同步收集粪检阳性患者的血液标本,采用间接ELISA法检测血清华支睾吸虫IgG抗体。分析EPG值与IgG抗体A450值的相关性,并根据华支睾吸虫感染度分类标准,分析轻度、中度和重度感染者EPG值与血清IgG抗体阳性率以及IgG抗体定性结果与EPG值的关系。在146份华支睾吸虫/扇棘单睾吸虫虫卵阳性粪样中,EPG最大值为21502,最小值为8。血清华支睾吸虫IgG抗体阳性率为84.9%(124/146),男、女性IgG抗体阳性率分别为86.0%(111/129)和13/17,差异无统计学意义(P>0.05)。感染者EPG值和IgG抗体A450值呈正相关性(rs=0.436,P<0.01)。轻度、中度和重度感染者IgG抗体阳性率分别为78.4%(69/88)、96.0%(48/50)和7/8,差异有统计学意义(P<0.05)。华支睾吸虫血清IgG抗体阳性组和阴性组粪样几何均数(GM EPG)值分别为736和204,差异有统计学意义(P<0.01)。提示在华支睾吸虫和扇棘单睾吸虫共感染的广西,粪样虫卵镜检和血清华支睾吸虫IgG抗体检测结果呈正相关;但单独粪便虫卵检查用于华支睾吸虫监测和诊断会存在误判,应辅助IgG抗体等血清学检测。In order to determine the endemic status and develop a diagnostic method for Clonorchis sinensis infection,the fecal eggs of C.sinensis and Haplorchis taichui and the specific IgG antibody in the sera of patients with suspected C.sinensis infections in Guangxi was examined.The fecal samples of suspected C.sinensis infected cases were collected from the Department of Preventive Health Examination,Guangxi Center for Disease Prevention and Control from March to September,2017.Kato-Katz thick smears were prepared from each stool sample in triplicate.The eggs of C.sinensis or H.taichui were examined and counted(EPG,egg per gram stool).Blood samples from fecal positive patients were collected and the serum IgG antibodies against C.sinensis were detected by indirect ELISA.The correlation between EPG and A450 value of IgG antibody was analyzed.The maximum EPG is 21502 and the minimum EPG is 8 among 146 eggs-positive fecal samples.The total positive rate of C.sinensis IgG antibody was 84.9%(124/146).The antibody positive rates in male and female patients were 86.0%(111/129)and 76.5%(13/17),respectively,without significant difference(P>0.05).There was a positive correlation between fecal egg EPG and serum C.sinensis IgG A450 value(rs=0.436,P<0.01).The positive rates of IgG antibody in patients with mild,moderate,and severe infection were 78.4%(69/88),96.0%(48/50)and 87.5%(7/8),respectively,and showed significant difference among them(P<0.05).The geometric mean of fecal EPG in individuals with C.sinensis IgG positive and negative were 736 and 204,respectively,with significant difference(P<0.01).There is a positive correlation between fecal egg count and C.sinensis IgG antibody titer in Guangxi,where C.sinensis and H.taichui are co-infected.However,there was false negative in the detection of C.sinensis infection by fecal examination alone,serological antibody detection could increase the diagnostic of C.sinensis infection.

关 键 词：华支睾吸虫 扇棘单睾吸虫 虫卵 IGG抗体 共感染 

分 类 号：R383.22[医药卫生—医学寄生虫学]