免疫滴金技术检测肾综合征出血热特异性抗体与中西医结合治疗426例的研究

A study on detecting specific IgM in 426 cases of hemorrhagic fever with renal syndrome with colloidal gold￣dot assay and treatment with traditional and western medicines

目的 为探索一种更为简便、快速、特异、灵敏的肾综合征出血热 (HFRS)抗体的检测方法及更为有效的中西医结合治疗方法。方法 42 6例HFRS病人血清同时采用免疫滴金法 (CGIDA)与酶联免疫吸附法 (ELLISA)对比检测特异性免疫球蛋M抗体 (抗HFRS IgM)、免疫灾光法 (IFAT)对比检测特异性免疫球蛋G抗体 (抗HFRS IgG)并以 2 0例发热待查、 48例病毒性肝炎血清作对照。 10 1例HFRS病人分组进行中西药结合治疗 ,治疗组用苦黄、参麦注射液联合黄芪汤 ,对照组用利巴韦林联合甘利欣注射液。结果 42 6例HFRS病人血清 ,以CGIDA法检测抗HFRS IgG ,阳性 32 8例 ,与ELLISA法作结果评价时 ,CGIDA灵敏度 78 9% ,特异度10 0 % ;以CGIDA法检测抗HFRS IgG ,阳性 387例 ,与IFAT法作结果评价时 ,CGIDA灵敏度90 8% ,特异度 10 0 %。治疗组 5 0例与对照组 5 1例用药后退热天数、主要症状缓解天数相似 (P>0 0 5 ) ,尿蛋白消失及肾功能恢复天数 ,对照组优于治疗组 (P <0 0 5 ) ,在越期方面 ,越休克期及从发热期直接进入多尿期 ,两组情况相似 (P >0 0 5 )。结论 CGIDA法检测HFRS特异性抗体分别与ELLISA法及IFAT法对照 ,均有简便、快速、特异、灵敏之优点 ,检测抗HFRS IgM ,CGIDA法敏感性差于ELLISA法 ,但是无假阳性 ;

Objective To explore a simple,rapid specific and sensitive method to detect specific IgM(SIgM)and IgG(SIgG)antibody in hemorrhagic fever with renal syndrome(HFRS).To study the therapeutic effects of traditional and western medicines on HFRS.Methods The serum of 426 patients with HFRS were tested with colloidal gold immuno dot assay(CGIDA)for SIgM and SIgG antibody and compared with enzyme linked immunosorbent assay(ELISA)or indirect fluorescent antibody test (IFAT)and a control group(20 fever of unknown origin and 48 hepatic disorders ).101patients with HFRS were randomized into a treatment group(n=50,kuhuang and Shenmai injection with Huangqi liquid)and a control group(n=51,Ribarvirin with Ganlixin injection).Results With CGIDA,specificity for SIgM was 100% and sensitivity was 78 9%,specifiafy for SIgG was also 100% sensitivity was 90 8%.They were similar during the period of clinical improvement between treatment group and control group.Days for recovery from albuminuria and normalized kidney function,the treatment group did better than the control one(P<0 05).The rate of recovery from the shock state was higher the treatment group than that of the control one(P<0 05).Conclusion To detect the SIgM or SIgG antibody in serum of patients with HFRS,CGIDA was more simple,rapid,more specific and sensitive than ELISA or IFAT.Though the sensitivity of CGIDA was lower than that of ELISA,the CGIDA had no false positive reaction;the sensitivity of CGIDA was higher than of IFAT on detecting anti HFRS IgG.Regarding treatment of HFRS,the effect of treatment group was similar to that of control group.But the rate of recovery from the shock state was higher in the treatment group than that of control,whereas normalization of kidney function in the control group was better than that in the treatment group.