应用单克隆抗体—抗原斑点试验检测血清抗原诊断黑热病的进一步研究

FURTHER STUDY ON THE APPLICATION OF McAb-AST TO THE DETECTION OF ANTIGENS IN SERUM FOR DIAGNOSIS OF KALA-AZAR

用单克隆抗体—抗原斑点试验(McAb-AST)又一次对50例黑热病确诊患者作血清抗原检测,以诊断黑热病。阳性率达100％。与前文报道的51例共计101例的阳性率为97.03％。509份对照血清(合计)中,假阳性反应1例(0.2％),特异性达99.8％。本文新病例乃在改进及简化方法基础上获得了更满意的效果。分析甘肃陇南、四川北部63例患者的年龄分布可见:10岁以下占65.1％;11—20岁,12.7％;21—30岁, 17.4％;21—40岁,4.8％;40岁以上无病例。符合山丘型黑热病的特点。本文总结出McAb—AST为敏感性高(97.03％),特异性强(99.8％)的黑热病实验断方法。经简化后,适合于广大基层单位推广使用,由于所需血清样品量微,取材方便,在儿童多发的山丘型黑热病疫区的应用,较之骨髓涂片诊断法的优越性,更显而易见。

In the present study, all of the 50 newly collected kala-azar patients＇sera tested by McAb-AST showed positive reaction, with a positive rate up to 100%. Including 51 cases reported before, the total number of cases has been accumulated to 101 with the average positive rate being97.03%, while 508 of 509 control sera(normal individuals and patients of other parasitic diseases) were negative in the test, with the false positive rate being as low as 0.2％. Age distribution of 63 cases from Gansu and Sichuan endemic areas showed that the majority(65.1％) of patients was below 10 years old. The rates of other age groups were 12.7％ in 11-20 years, 17.5％ in 21-30 years, 4.8％ in 31-40 years and zero in groups above 40 years old, which is in accordence with characters reported by others. McAb-AST is more convenient for field application based on the sim-plified and modified procedures described in this paper. It is suggested that McAb-AST is a simple, sensitive(97.03％) and specific method(99.8％), and may be considered the first choice method in the diagnosis of kala-azar, especially in the endemic areas with high morbidity among young children.