肝吸虫病常用诊断方法的效果评估

Evaluation on regular diagnostic methods for clonorchiasis

目的：评估酶联免疫方法用于辅助诊断肝吸虫病的效果。方法采用酶联免疫方法（ELISA）和Kato- Katz方法，对2009～2010年在哈尔滨医科大学人体寄生虫病研究所就诊的疑似肝吸虫病患者进行检测，利用贝叶斯统计方法计算ELISA和Kato- Katz方法的敏感性和特异性。结果共对2359人临床疑诊为肝吸虫病患者进行了检测。酶联免疫方法（ELISA）检测抗体阳性率40.44%（954/2359），Kato- Katz方法粪便中虫卵检出率为21.75%（513/2359），血清ELISA阳性率明显高于粪便虫卵检出率（P〈0.05）。其中，血清ELISA方法敏感性为98.7%、特异性为76.53%、阳性预测值为54.66%、阴性预测值达99.52%，与粪便虫卵检出法的吻合度系数为0.564。结论粪便检查联合血清ELISA法可用于提高肝吸虫病的诊断率。

Objective To evaluate the effect on the diagnosis of clonorchiasis by enzymelinked immunosorbent assays （ELISA） as a supplementary method. Methods From 2009 to 2010, the patients with suspected clonorchiasis visited to institute of parasitology, Haerbin medical university were determined with the method of ELISA and Kato- katz. Statistic method of Bayesian was used to calculate the sensitivity and specificity. Results The total of 2 359 patients with suspected clonorchiasis were determined. The antibody-positive rate determined by ELISA was 40.44%（954/2 359）, and the egg- positive rate found by examination of feces was 21.75%（513/2 359）. The positive rate of ELISA was significantly higher than that of Kato katz（P〈0.05）. The sensitivity, specificity, positive predictive value and negative predictive value of ELISA were 98.7%, 76.53%, 54.66% and 99.52%, respectively. The agreement between the two methods was 0.564. Conclusion The combination of ELISA and Kato katz could improve the diagnostic accuracy of clonorchiasis.