四种免疫学检查在脑囊虫病诊断和治疗中的应用

Value of four immunological techniques in diagnosis and treatment of cerebral cysticercosis

目的探讨4种免疫学检查在脑囊虫病诊治中的应用价值及临床意义。方法对确诊的脑囊虫病病人治疗前后血清及脑脊液进行间接血凝试验(IHA)、酶联免疫吸附实验(ELISA)、囊虫循环抗原(CAg)以及短程抗体(IgG4)检测,并对其检测结果进行分析比较。结果治疗前脑囊虫病人血清IHA、ELISA、CAg、IgG4阳性率分别是68.28%、65.19%、51.54%和63.84%。脑脊液IHA、ELISA、CAg、IgG4阳性率分别是30.68%、39.98%、46.03%和41.94%。治疗后血清IHA、ELISA、CAg、IgG4阳性率分别是67.40%、65.63%、12.33%和11.89%。结论血清及脑脊液IHA、ELISA检测囊虫循环抗原(CAg)以及短程抗体(IgG4),对囊虫病诊断方面均有一定的敏感性,但因抗体可持续数年,因此IHA、ELISA不能作为疗效考核的指标。囊虫循环抗原(CAg)检测以及短程抗体(IgG4)检测可作为疗效考核的指标。

Objective To investigate the value and the clinical significance of several immunological examinations in diagnosis and treatment of cerebral cysticercosis.Methods Indirect haemagglutination test（IHA）,enzyme-linked immunosorbent assay,（ELISA） were used for detection of circulating antigen（CAg） and immunoglobulinG4（IG4） in serum and cerebrospinal fluid of confirmed cerebral cysticercosis patients before and after treatment and the results were compared.Results Before treatment,serum positive rates of IHA ELISA,CAg and IgG4 were 68.28%,65.19%,51.54%,63.84%.The cerebrospinal fluid positive rates of IHA,ELISA,CAg and IgG4 were 30.68%,39.98%,46.03%,41.94%.After treatment,serum positive rates of IHA,ELASL,CAg and IgG4 were 67.40%,65.63%,12.33%,11.89%.Conclusion The methods of IHA and ELISA and the detection of CAg and IgG4 in serum and cerebrospinal fluid are sensitive in diagnosis of cerebral cysticercosis,because the antibody can last many years..IHA and ELISA can not be used as indicators in assessment of therapeutic effect,but the detection of CAg and IgG4 do.