慢性血吸虫病吡喹酮治疗前后血清循环抗原水平的变化

OBSERVATIONS ON THE LEVEL OF SERA CIRCULATING ANTIGEN OF PATIENTS WITH CHRONIC SCHISTOSOMIASIS JAPONICA BEFORE AND AFTER TREATMENT WITH PRAZIQUANTEL

目的观察慢性血吸虫病患者吡喹酮治疗前、后血清血吸虫肠相关趋阴极抗原（ＧＡＣＡ）水平的变化。方法Ｋａｔｏ－Ｋａｔｚ法粪检确定慢性血吸虫病患者６４例，随机分成２组。治疗组３３例，对照组 ３１例，分别给予口服 ４０ｍｇ／ｋｇ剂量吡喹酮和安慰剂。采用单克隆抗体斑点酶联免疫吸附试验（ＭＣＡｂ－Ｄｏｔ－ＥＬＩＳＡ）分别检测 ２组患者治疗前和治疗后 ２、８、２４ ｈ和 ４８ ｈ血清ＧＡＣＡ水平。结果 治疗组服药后２ｈ，血清ＧＡＣＡ水平迅速上升，平均较服药前升高３个滴度。后渐降，至服药后４８ｈ，血清ＧＡＣＡ水平仍高于服药前１个滴度；同时，血清ＧＡＣＡ的阳性检出率，也由服药前的７２． ７％提高到服药后 ２ｈ的 １００．０％。对照组同期血清ＧＡＣＡ水平和阳性检出率均无明显变化。结论吡喹酮通过刺激血吸虫虫体释放ＧＡＣＡ，可显著提高慢性血吸虫病患者血清ＧＡＣＡ水平和检测敏感性。

Objective To observe the effect of praziquantel on the serum gut-associated cathodic antigen (GACA ) levels in the patients with chronic schistosomiasis before and after treatment. Methods Sixty-four cases of patients with chronic schistosomiasis diagnosed by Kato-Katz method were divided into 2 groups random, which were given praziquantel at the dosage of 40 mg/ kg and placebo respectively. The serum samples were collected and detected by McAb-Dot-ELISA before treatment and at 2 .8,24 and 48 h after treatment. Results The serum GACA level of the treatment group at 2 h after treatment was higher than that before treatment by 3 titers. From then on,the titer was decreased gradually,and the serum GACA level was still 1 titer higher than that before treatment until 48h after treatment. The positive detection rate of serum GACA was raised from 72. 7 % before treatment to 100. 0% at 2 h after treatment. However, there were no obvious changes on the serum GACA level and positive detection rate in the control group during the same period of observation. Conclusion Praziquantel could increase the serum GACA levels of the patients with chronic schistosomiasis by stimulating the worms to release GACA as well as the sensitivity of GACA detection effectively.