囊虫病循环抗原检测结果用于疗效考核的研究

Detection of circulating Antigen of cysticercus cellulosae in checking curative effect

目的 查明囊虫死亡后患病机体内循环抗原(CA)的变化规律,以此为依据判定CA检测作为疗效考核标准的可行性。方法 用囊虫循环抗原检测试剂盒,对15头囊虫病猪和15例囊虫病患者治疗前后血清CA的变化情况作了观察。结果 用吡喹酮治疗囊虫病猪15头,经剖检证实治愈者13头。其中10头在治疗后15天血清中CA的衰减幅度大于2,治疗30天后13头猪的血清CA衰减幅度大于2,其中3头猪的CA已转阴;治疗后60天CA转阴的猪达10头。未治愈的两头病猪的CA一直变化不大。对囊虫病患者15例,用丙硫咪唑治疗,其中9例经1疗程治愈,治疗后30天的CA衰减幅度大于2,治疗60天后CA全部转阴;3例经2疗程治愈,60天后CA的衰减幅度大于2,1例转阴;2例经3疗程治愈,治疗后90天的CA衰减幅度大于2;另1例严重感染患者经6疗程治疗未治愈,其血清CA的衰减幅度小于2。结论 血清的CA吸光度(absorbance)A值变化能准确反应囊虫在患者体内的生存状态,以治疗前后的CA衰减幅度大于2或消失可作为囊虫病治愈的考核依据。

Objective To investigate the law of CA changing value in patient after the death of cysticercus cel-lulosae so as to establish the standard for checking the curative effect of CA treatment. Methods The changes of A value of CA(CA A) in blood supernatant of 15 pigs suffering from cysticercosis and 15 cases suffering from cysticercosis were investigated. Results 15 pigs suffering from cysticercosis were treated with Praziguan-tel, 13 were cured confirmed by autopsy. The attenuating ranges of CA in blood supernatant of 10 in 13 cured pigs were higher than 2 on 15 days and all were higher than 2 after being treated for 30 days. 3 in 13 cured pigs the CA turned to be negative after treatment for 30 days and 10 pigs the CA turned to be negative after treatment for 60 days. The change of CA A was not notable in 2 incurable pigs after treatment. 15 patients infected by cysticercosis cellulosae were treated with Albendazole, 9 of which had been cured by one course of treatment. The attenuating range of CA A was above 2 after 30 days for treatment. The CA tests of 9 patients were negative after 60 days for treatment; the attenuating range of CA in 3 patients cured by two courses of treatment was higher than 2 and one of them with CA negative. There were 2 patients cured by three courses of treatment with the attenuating range of CA A higher than 2. 1 severe patient was not cured after treatment with six courses, the attenuating range of CA A in blood supernatant was lower than 2. Conclusions The changes of CA A value may reflect the state of the existence of cysticercus cellulosae in the body and the attenuating range of CA higher than 2 or negative may refer as a checking basis for cure.