免疫学方法联合检测血吸虫病的初步研究

Preliminary Study of Immunological Methods for Combined Detection of Schistosomiasis

目的了解血吸虫病血清学检测方法的联合应用的效果,为制定防治对策提供科学依据。方法选择46例慢性血吸虫病患者及42例健康人作为研究对象,采用间接血凝法(IHA)、金标渗滤法(DIGFA)、酶联免疫吸附试验(ELISA)分别检测其抗原和抗体,了解3种方法的敏感性与特异性,以及3种方法不同组合的检出阳性差别。结果IHA抗体检测敏感性为76.09%,特异性为95.24%;DIGFA抗体检测敏感性为69.57%,特异性为97.62%;ELISA循环抗原检测敏感性为32.61%,特异性为92.86%;任意2种方法阳性联合判定总的敏感性为65.22%,特异性为97.62%;3种方法同时阳性联合判定的敏感性为23.91%,特异性为100%。结论血吸虫病血清学检测循环抗原敏感性和特异性较差;任意2种方法联合阳性判定总的敏感性与特异性与单独IHA、DIGFA相似,无实际意义;检测抗体的IHA、DIGFA和检测循环抗原的ELISA3种方法联合阳性判定的敏感性与循环抗原ELISA相似,但特异性高,似与病原学诊断有相仿的意义,可在流行病学调查研究中结合运用。

Objective To explore the effect of serological assay combined detection of schistosomiasis and pro- vide scientific basis for schistosomiasis prevention and control. Methods A sample of 46 cases with chronic schistosomiasis as well as 42 healthy individuals were selected to compare sensitivity and specificity of IHA, DIGFA, ELISA by detecting the antigen and antibody. Results The sensitivity and specificity were 76.09% and 95.24% in IHA, 69.57% and 97.62% in DIGFA, 32.61% and 92.86% in circulating antigen ELISA, 65.22% and 97.62% in any two method combination and 23.91% and 100% in combination of all the three, respectively. Conclusion Circulating antigen ELISA is with inferior sensitivity and specificity. The total sensitivity and specificity in combination of any two methods are equivalent to IHA, DIGFA. The sensitivity of combination of IHA, DIGFA and ELISA is equivalent with ELISA yet superior in terms of speci-ficity, showing a similar significance with etiology diagnosis and feasibility in epidemiological investigation.