18kDa抗原诊断泡型包虫病的评价

EVALUATION OF DIAGNOSTIC VALUE OF 18 kDa ANTIGEN IN ALVEOLAR ECHINOCOCCOSIS *

目的：评价１８ｋＤａ抗原在泡型包虫病（ＡＥ）诊断中的价值。方法：用免疫印渍法检测３３例泡型包虫病、６９例囊型包虫病（ＣＥ）、３０例囊虫病和８２例健康人血清对泡型棘球蚴（Ｅｍ）和囊型棘球蚴（Ｅｇ）原头节１８ｋＤａ抗原的抗体反应。同时用羊包囊液抗原常规ＥＬＩＳＡ法检测上述血清。结果：ＥＬＩＳＡ试验，ＡＥ血清阳性率为９３．９％、ＣＥ为８５．５％、囊虫病为５０％、健康人为６．１％。显示３种患者血清存在较强的交叉反应。免疫印渍试验，两种原头节的１８ｋＤａ抗原对ＡＥ血清阳性反应均为９０．９％、ＣＥ分别为１０．１％和１３％、囊虫病患者为１３．３％和１６．７％。与健康人血清不发生反应。结论：１８ｋＤａ抗原可以有效的鉴别两型包虫病。

AIM: To evaluate the 18 kDa antigen in diagnosis of human alveolar echinococcosis. METHODS: A total of 214 sera from patients with alveolar echinococcosis (AE, 33), cystic echinococcosis (CE, 69), cysticercosis (30) and healthy controls (82) were examined by Western blotting to detect the antibodies against 18 kDa antigen using both antigens from protoscoleces of E.granulosus (Eg) and E.multilocularis (Em). All the sera were tested simultaneously by ELISA to detect the antibodies against hydatid cystic fluid antigens of sheep as a comparison. RESULTS: The positive rate by ELISA was 93 9% in AE, 85 5% in CE, 50% in cysticercosis and 6 1% in healthy controls, respectively, suggesting a critical cross reaction and a certain degree of nonspecific reaction. The serum positive rates by Western blotting with the 18 kDa antigen of Eg and Em were 90 9% and 90 9% in AE, 10 1% and 13% in CE, 13 3% and 16 7% in cysticercosis, respectively. No positive was found in the sera from healthy controls. CONCLUSION: The 18 kDa antigen may be used in the differential diagnosis of AE from CE.