不同检材检测钩端螺旋体病的平行比对研究

A parallel and comparative study on detection of leptospirosis in different samples

目的:了解不同检材中血清及脑脊液对钩端螺旋体病检测的影响因素,研究患者体内钩端螺旋体的感染状况,平行对比分析探讨二种检材的优劣。方法:标本系同时采集血清及脑脊液进行检测,试验方法选择钩体病的显微镜凝集试验(MAT)。结果:血清MAT总感染率为35.07%(47/134),其中血清阳性率为11.19%(15/134)、血清弱阳性率为23.88%(32/134);而脑脊液阳性率为2.24%(3/134)。血清及脑脊液阳性率及弱阳性率两者数据经用行X列表的显著性检验比较得出χ2=24.01,P<0.01,二者间存在高度的显著性差异;血清及脑脊液的感染率经用四格方表的显著性检验得出其卡方值χ2=5.68,P<0.05,两者间存在显著性差异。结论:当病人处于急性感染期时,血清中显微镜凝集试验(MAT)其钩体菌群滴度达1∶1600时,脑脊液才会同时表现为阳性。表明试验检材中血清比脑脊液检出率要高。由于采集患者血清检测钩体病比脑脊液要容易,且对患者损伤小,体现了血清的优势,因此采集血清不但可提高检出率同时能减轻对患者身体的损害。

Objective：To evaluate and compare the value of serum and cerebrospinal fluid （CSF） samples in di- agnosis of leptospirosis and to understand the prevalence of leptospirosis in patients. Methods： Both serum and CSF samples were collected from patients and tested for leptospira by microscopic agglutination test （MAT）. Results： The overall positive rate in serum samples was 35.07% （47/134）, including a strong positive rate of 11.19% （ 15/ 134） and a weak positive rate of 23.88% （32/134） ; while the positive rate in CSFs was only 2.24% （3/134）. The difference of positive rates in serum and CSF samples was statistically significant （X2 =24.01 ,P 〈0.01 ）. The prevalence of leptospira was significantly different between serum and CSF samples （X2 = 5.68, P 〈 O. 05 ）. Con- clusion： In acute samples, CSFs gave a positive MAT result only when the MAT titer in sera reached 1：1600, indi- cating the detection rate in sera was higher than that in CSFs. Furthermore, serum samples have the advantages over CSFs that they are easier to obtain and less traumatic, and therefore serum is the suitable sample in diagnosis of lep- tospirosis.