FLA—ABS·T/PGI—ELISA及其在麻风免疫流行病学研究中的应用

FLA-ABS.T/PG1-ELISA and Their Use in Immuno-Epidemiological Studies for Leprosy

用大样本系统地比较了FLA—ABS.T和PGI—ELISA的可靠性和实用性。结果表明FLA—ABS.T和PGI—ELISA均高度敏感和特异,其正确指数及阳性和阴性顶测值均>90％。以PGI—ELISA更加简、便、廉、速,所以更适于做为麻风免疫流行病学研究的工具。文中讨论了耳垂血滤纸干血渍斑法的优点及其在大规模麻风免疫流行学研究中的用途,并提出了麻风“亚感区”和“诊断线”的概念。

A comparison study between FLA-ABS. T and PG1-ELISA for their reliability and practicality has been conducted in 284 cases of leprosy, 20 ones of tuberculosis, 172 healthy persons as controls from an area without leprosy patients, 425 houshold contacts (HC) and 2573 persons of random population(PF). The results indicated that the two tests are highly sensitve and specific for detecting anti-bodies against M. leprae. Their correct indices (CI) and expected values of positivity and negativity are all higher than 90％. In addition, several agreements between the two tests have been found in leprosy immuno-epidemiological studies as well: 1)The positive rates increased gradually from TT to LL of leprosy in FLA-ABS. T and PG1-ELISA, and PG1-ELISA's positive rate in HC of multibacillary patients is higher than that in HC of paucibacillary ones. 2)The positive rates of FLAABS. T and PG1-ELISA are identical either in HC or in RP. 3)For RP in different districts, the positive rates of the tests are similar and concordant with general trend of the prevalence in the locality On the basis of above-mentioned results, the FLA-ABS. T and PG1 ELISA might be regarded as useful tools in the diagnosis of leprosy, detection of subclinical infection with M. leprae and relevant immuno-epidemiological studies. However, because of simpler, rapid, cheaper and easier to its use, the PG1-GLISA is more practical than FLA-ABS. T. On the other hand, it is emphasized that the methodology of dried blood from theear lobe is very important in achiev ing leprosy field immuno-epidemiological studies on a large scale. Besides, the authors put forward two preliminary concepts of 'subclinical infection zone' and 'diagnostic line' for the test.