酶联免疫斑点法检测抗1型单纯疱疹病毒IgM分泌细胞在单纯疱疹病毒性脑炎早期诊断中的作用

The role of anti-herpes simplex virus-1 IgM secreting cells detection assay in the early diagnosis of herpes simplex encephalitis

目的观察酶联免疫斑点法（ELISPOT）检测抗1型单纯疱疹病毒IgM（抗-HSV-1 IgM）分泌细胞在单纯疱疹病毒性脑炎（HSV-1脑炎）早期诊断中的作用并探讨其价值。方法采用ELISPOT法和ELISA法分别检测患者脑脊液中的抗-HSV-1 IgM分泌细胞和抗-HSV-1 IgM，并对HSV-1脑炎23例、临床对照组40例进行回顾性分析，统计学处理采用Fisher精确检验法。结果ELISPOT法检测HSV-1脑炎组9例患者2周内脑脊液中抗-HSV-1 IgM分泌细胞，8例阳性，敏感度为88．9％；临床对照组检测16例，15例阴性，特异度为93．8％。ELISA法检测HSV-1脑炎组12例患者脑脊液2周内抗-HSV-1 IgM，2例阳性，敏感度为16．6％；临床对照组检测17例，15例阴性，特异度为88．2％。两种方法敏感度比较差异有统计学意义（P〈0．01）。结论应用ELISPOT法检测HSV-1脑炎患者脑脊液中抗-HSV-1 IgM分泌细胞优于ELISA方法检测抗-HSV1IgM，具有更好的早期诊断意义。

Objective To investigate the role of anti-herpes ximplex virus （HSV）-1 IgM secreting cells detection assay in early diagnosis of herpes simplex encephalitis. Methods Twentythree herpes simplex encephalitis cases and 40 control cases were included in this study. Anti-HSV-1 IgM secreting cells and anti-HSV-1 IgM were retrospectively tested in the patients＇ cerebrospinal fluid by enzyme-linked immunosorbent spot （ELISPOT） and enzyme-linked immunosorbent assay （ELISA）, respectively. The data analysis was performed by using Fisher Exact Test. Results Using ELISPOT method for detection of 9 HSV-1 encephalitis patients＇ and 16 clinical control cases anti- HSV-1 IgM secreting cells within two weeks after disease onset, the sensitivity of ELISPOT for detecting anti HSV-1 IgM secreting cells in the cerebrospinal fluid was 88.9% （8/9） and the specificity was 93.8%（15/16）. On the other hand, the sensitivity of ELISA for detecting anti HSV-1 IgM in cerebrospinal fluid was 16. 6% （2/12） and the specificity was 88. 2%（15/17） when using ELISA method for detection of 12 HSV-1 encephalitis patients＇ and 17 clinical control cases＇s anti-HSV-1 IgM secreting cells. The sensitivities of the two methods were statistically different （P〈0.01）. Conclusion Compared to ELISA, ELISPOT for detecting the anti-HSV-1 IgM secreting cells in cerebrospinal fluid is a more sensitive method for early diagnosing herpes simplex encephalitis.