混合或单一单抗检测肺吸虫病人血清中循环抗原的研究

DETECTION OF PARAGONIMUS CIRCULATING ANTIGENS IN SERA BY DOUBLE ANTIBODY SANDWICH一ELISA WITH MIXED AND SINGLE MONOCLONAL ANTIBODIES

本文报道应用由７种抗卫氏并殖吸虫囊蚴和成虫单克隆抗体（ＰｗＭ和ＰｗＡ一ＭｃＡｂ）组成的混合ＭｃＡｂ一ＥＬＩＳＡ法检测辽宁省凤城县肺吸虫病流行区２０８份滤纸血循环抗原（ＣＡｇ），阳性率为３８％（７９／２０８）。对１００份同时有滤纸血和血清样本者同步检测进行比较，滤纸血ＣＡｇ阳性率为６２％（６２／１００），血清ＣＡｇ阳性率５７％（５７／１００），符合率为９１％，经确切概率法处理两者无显著性差异，说明滤纸血可代替血清作ＣＡｇ检测。分别用７种ＭｃＡｂ检测５５份混合ＭｃＡｂ检测为阳性的样本，４种抗囊蚴ＭｃＡｂ中Ｇ＿２Ｂ＿３检出率最高，Ａ＿３Ａ＿７次之，３种抗成虫ＭｃＡｂ中Ａ＿３Ｄ＿３检出率最高，表明用Ｇ＿２Ｂ＿３或Ａ＿３Ａ＿７与Ａ＿３Ｏ＿３混合检测Ｐｗ病人ＣＡｇ更省更好。但在斯氏肺吸虫流行区应首选Ａ＿２Ｅ＿７，因其与斯氏Ａｇ有强烈的交叉反应，对斯氏肺吸虫患者血清ＣＡｇ检出率高达９４．７％（１８／１９）。本研究结果提示上述７种ＭｃＡｂ单独应用或不同组合后应用有助于提高ＣＡｇ的检出率并有助于肺吸虫感染虫种和虫期的判别。

Specimens of sera and blood on filter 一paper were collected from residents with posi-tive skin tests of Paragonimus westermani (Pw)in endemic area of Fongcheng county, Liaoningprovince. Paragonimus circulating antigens (CAg)in the specimens were detected with 7 mixed andsingle monoclonal antibodies(McAb)to metacercaria and adult worm of Pw by double antibody sand-wich一ELISA (DAS一ELISA ).The main results are as follows: 1.CAg detection rate in 208 specimens of blood on filter 一paper from residents with positive skintests was 38%(79/208)by mixed 7 McAb DAS一ELISA.2.The positive rates in blood on filter一paper and sera from same 100 residents with positive CAgdetection were 62%(62/100)and 57(57/100)respectively by mixed 7 McAb DAS一ELISA.Con-formable rate was 91%。T test showed that they are no significant difference. It suggested that it ismuch simpler and easier to use bled on filter一paper instead of sera for CAg detection.3.Fifty five cases with positive CAg were chosen for comparative study of CAg detection amongeach of 7 McAbs. The comparative study showed that G_2B_3 is best one,A_3A_7 is second among 4PwM一 McAb;A_3D_3 is best one for CAg detection;G_2B_3 or A_3A_7 mixed with A_3D_3 for Pw CAg detection isbest combination.4Since the CAg positive rate of patients with Pagumogonimus skr jabini(Ps)infection was 94.7%(18/19)with A_2E_7,strongly reacted with Ps Ag,A_2E_7 single could apply to CAg detection of pa-tients with Ps infection.5.Seven McAb might be applied singly or in different combination for increase in CAg detectionrate,differential diagnosis of the parasite species and stages.