金黄色葡萄球菌A蛋白协同凝集试验检测慢性血吸虫病患者循环抗原的研究

DETECTING CIRCULATING ANTIGEN IN PATIENTS OF CHRONIC SCHISTOSOMIASIS USING STAPHYLOCOCCUS PROTEIN A CO AGGLUTINATION TEST

目的：探讨金黄色葡萄球菌Ａ蛋白协同凝集试验的敏感性、特异性及疗效考核价值。方法：检测用吡喹酮治疗前后７２例慢性血吸虫病患者和对照组的血清。结果：慢性血吸虫病患者血清阳性率９３．１％（６７／７２），血清循环抗原水平与每克粪便内虫卵数（ＥＰＧ）无明显相关，正常人血清假阳性率３．２％（３／９５），１０例华支睾吸虫病患者血清中有１例阳性，其他病患者１１例血清均阴性。血吸虫病患者治疗后３个月，粪检阴转者中８０．７％（４６／５７）血清抗原亦转为阴性，粪检阳性者血清抗原检测仍为阳性，所有阳性血清抗原滴度均较治疗前明显下降。结论：金黄色葡萄球菌Ａ蛋白协同凝集试验能用于血吸虫病诊断和疗效考核，并有简易、快速和费用低廉的优点。

AIM: To determine the sensitivity, specificity and efficacy evaluation capacity of the staphylococcus protein A co agglutination test(SPA CoA) in detecting circulating antigens in the patients of chronic schistosomiasis.METHOD: Sera from 72 chronic schistosomiasis patients were examined before and after treatment. RESULTS: A positive rate of 93.1%(67/72)was achieved in chronic cases before treatment.No significant correlations were found between EPG and the antigen titres(r=0.0256, P >0.05).In healthy controls,3 out of 95 were positive,accounting for a false positive rate of 3.2%.For cross reactions,only 1 out of 10 clonorchiasis patients was positive and none was found positive in 11 non parasitic di sease controls .Three months after treatment,80.7%(46/57)of the patients followed up with negative fecal examinations showed negative conversion in serum antigen detections.All the patients remained fecal egg positive still showed SPA CoA positive,but the antigen titers were much reduced than those before treatment. CONCLUSION: With simplicity,rapidity and low cost,SPA CoA is recommended to be used in the diagnosis of schistosomiasis as well as in the evaluation of therapeutic efficacy.