日本血吸虫病循环抗原检测的合作研究(英文)

COLLABORATIVE STUDY ON DETECTION OF CIRCULATING ANTIGENS IN SCHISTOSOMIASIS JAPONICA

１９９３年５月，在湖南省寄生虫病防治研究所（湖南岳阳）举行了一次有关日本血吸虫循环抗原检测的联合测试研讨会，来自全国流行省（市）的８个单位派员及携带自己在过去几年中研制的检测系列（包括试剂和技术方法）参加了此项研究，在同一时间和地点，对同一批５７０份血清样本（包括正常人、现症病人、治后不同时期及其他常见寄生虫病人血清）进行了双盲法检测。结果表明：假阳性率除检测系统Ｂ为２％以外，其余７个系统的假阳性率在１４％—４６％之间；敏感性在急性病例为９５％—１００％，慢性病例的检出率在检测系统Ａ及Ｆ分别为７３．３％及７２．７％，其余在７０％以下；各系统测试治后１年内血清的转阴率未超过１／３，２年内转阴率除系统Ｅ为６０％以外，其余未超过５０％（系统Ｈ因敏感性太低除外）。以上说明，参加合作研究的８个测试系统尚需从提高特异性和／或敏感性两个方面进行改进。至于疗效考核不满意的原因，除与试验的特异性不高和治疗效果差有关外，需作进一步分析。

A workshop for collaborative study on circulating Schistosoma japonicum antigen detection was held at the Hunan Institute of Parasitic Diseases, Yueyang, Hunan Province in May, 1993. Eight laboratories from schistosomiasis endemic provinces(municipalities) were joined in this study. Scientists from these laboratories performed serological assays in blind using their own brought test systems that developed during recent years. The serum samples tested covered 100 non endemic controls, 190 from patients with active schistosomiasis, 110 from cured cases of schistosome infection, and 170 from individuals harbouring other parasitic infections or hepatitis. Results of the study revealed an assay specificity, in terms of false positive rate, of 2% in Series B versus 14-46% in the other 7 series. With regard to assay sensitivity, all test series showed 95 100% for acute cases. While for chronic cases, test series A and F demonstrated sensitivities at 73.3% and 72.7% respectively. Other series were all below 70%. Negative reversion rates for sera from cured cases within 1 year post treatment were below 33.3%, those within 2 years were 60% for Series E, while below 50% for all others except the Series H which was excluded due to an extremely low sensitivity obtained. The low values of these test series for chemotherapy assessment may be attributed to the poor specificity of the detecting systems used and/or the sample donors being not totally cured. It is strongly indicated that all the 8 test systems involved in the present study should further be improved in sensitivity, specificity as well as in capacity for pre and post treatment evaluations.