协同凝集试验在胆囊棘球蚴病的诊断应用

Studies on the laboratory diagnosis of cystic echinococcosis by coagglutination test

目的 建立一种简便快速、经济实用的胆囊棘球蚴病 (cysticechinococcosis ,CE)的实验诊断方法。方法 以自制兔抗棘球蚴抗血清建立一种检测CE患者血清或尿液中棘球蚴抗原 (H -Ag)的玻片协同凝集 (Co -A)试验 ,并用于检测 30例CE患者、2 0例其他寄生虫病和 2 5例健康人血清及尿液中的H -Ag ,并评价该法的灵敏度、特异度、阳性预测值和阴性预测值。结果 CE患者浓缩尿液和血清中H -Ag的总检出率分别为 77%及 83 % ,其中手术诊断CE组浓缩尿液和血清中H -Ag的检出率分别为 83 %及 92 % ,超声检查证实CE组为 75 %及 88% ,临床诊断CE为 70 %及 80 %。应用Co -A试验检测患者浓缩尿液和血清中H -Ag的灵敏度、特异度、阳性预测值和阴性预测值分别为 77% ,87% ,93 %和 96 % ;89% ,93 % ,86 %和 92 %。结论 Co -A试验是临床上诊断CE的一种简便快速、经济实用的实验诊断方法 。

Objective To establish a cost-effective,rapid,simple,and practical test for diagnosis of cystic echinococcosis(CE).Methods Slide coagglutination (Co-A), which used to dectect patient's serum or urine bydatid antigen (H-Ag), was established by applying self-made rabbit anti-echinococcosis serum. Sensitivity, specificity, positive and negative predictive value were evaluated by measuring serum and urine H-Ag in 30 CE patients, 20 cases infected by other patients and 25 health controls. Results The detective rates of the H-Ag in CE concentrated urine and serum were 77%(23/30) and 83%(25/30),respectively the dectective rates of H-Ag in surgical confirmed CE patients' concentrated urine and serum were 83% and 92%, ultrasound confirmed CE group were 75% and 88%, clinical diagnosed group were 70% and 80%. The sensitivity,specificity,postive predictive value,and negative predicative value of the Co-A test ( urine and serum) were 77% and 87%,93% and 96%,89% and 93%,86% and 92%, respectively.Conclusion Co-A test has the potential to be used as a simple,rapid,practical,and economical slide agglutination test for clinical diagnosis of CE.