消灭丝虫病地区病原学监测方法的研究

STUDIES ON ETIOLOGICAL SURVEILLANCE IN FILARIASIS-ELIMINATED AREAS

为筛选适宜在消灭丝虫病地区应用的简易、经济、实用的病原学监测方法 ,对单克隆抗体 (Mc Ab) - EL ISA检测丝虫特异 Ig G4和快速免疫色谱技术 (ICT)检测血清和血浆中的班氏丝虫抗原诊断丝虫病的效果进行对比研究。结果检测班氏微丝蚴血症者 5 9例 ,丝虫特异 Ig G4阳性 5 7例 ,阳性率 96 .6 1% ;ICT丝虫抗原阳性 5 6例 ,阳性率为 94.92 %。两种方法均具有较高的敏感性 ,差异无显著性 (P>0 .0 5 )。同时分别检测非流行区健康者 40人 ,囊虫病患者 30例及 2 5例华支睾吸虫病患者血清 ,两种方法均呈阴性 ,未出现交叉反应 ,特异性为 10 0 %。现场研究两种方法分别检测基本消灭丝虫病后出生儿童 30 2人 ,消灭丝虫病地区人群 372人 ,晚期丝虫病患者 5 5例 (乳糜尿41例 ,象皮肿 14例 ) ,原微丝蚴血症转阴者 6 0例。结果仅消灭丝虫病地区人群中 1例 (以往血检阴性 )丝虫特异Ig G4强阳性 ,ICT丝虫抗原弱阳性 ,但反复镜检未发现微丝蚴。其余均为阴性。研究表明 ,两种方法均具有较高的敏感性和特异性 ,均可用于消灭丝虫病地区病原学的监测。Mc Ab- EL ISA检测丝虫特异 Ig G4可大面积用于消灭丝虫病地区的病原学监测。而 ICT检测班氏丝虫抗原更适用于个案病例的检测。

In order to screen a simple, economical and applicable etiological method, a comparison was made on McAb ELISA for detecting specific IgG4 and ICT for detecting antigens of Filaria bancrofti in serum and plasma. As a result, out of 59 microfilaremia cases, specific IgG4 was found in 57 (96.61%) and filarial antigens in 56 cases (94.92%), indicating McAb ELISA and ICT were both high sensitive and no significant difference existed between them ( P >0.05). No false positive result occurred by both methods in examining sera of 40 health persons from non endemic area, 30 cases with cysticercosis and 25 cases with clonorchiasis. In a field study, McAb ELISA and ICT were used in examination of 302 children born after the elimination of filariasis, 372 persons in filariasis eliminated area, 55 cases with advanced filariasis (41 with chyluria and 14 with elephantiasis) and 60 persons who had become negative from microfilaremia. Only one person in filariasis eliminated area was strongly positive for specific IgG4 and weakly positive for filarial antigens. However, no microfilaria was found in this case by repeated blood smear examination. The results proved that McAb ELISA and ICT both with high sensitivity and specificity were applicable in etiological surveillance in filariasis eliminated area, and the former was better for a large scale etiological monitoring in filariasis eliminated area and the latter was better in a case diagnosis.