日本血吸虫虫卵组分抗原现场查病价值的评价

FIELD EVALUATION OF FRACTION ANTIGEN OF SEA APPLIED IN SCREENING OF SCHISTOSOMIASIS

目的 评价日本血吸虫虫卵 10 7/ 12 1ku组分抗原在现场查病中的应用价值。 方法 采用虫卵可溶性 10 7/ 12 1ku组分抗原酶联免疫吸附试验 (FA- EL ISA)与双面胶纸条环卵沉淀试验 (DGS- COPT)和粪便孵化法平行试验的方法 ,观察其在现场查病中的敏感性、特异性和阳性检出率的符合情况。 结果 虫卵 10 7/ 12 1ku抗原 FA- EL ISA现场检测粪阳病人的阳性率为 92 .6 8% ,血吸虫病治愈后 8～ 18个月人群的假阳性率为 4 2 .2 5 % ,对治疗后 8、12、18个月的阴转率分别为 36 .36 %、4 8.15 %、90 .90 % ;该抗原与 DGS- COPT平行检测现场普查血清的阳性率分别为 9.4 3%和 2 1.0 0 % (χ2 =2 9.14 10 ,P<0 .0 1) ;虫卵 10 7/ 12 1ku组分抗原和 DGS- COPT有相关关系 (rn=0 .6 2 6 3) ,DGS- COPT和粪便孵化无相关关系 (rn=- 0 .3783) ,虫卵 10 7/ 12 1ku组分抗原与粪便孵化有相关关系 (rn=0 .4 32 4 )。 结论 虫卵 10 7/ 12 1ku组分抗原的检测结果更接近于粪便孵化法 ,现场应用的价值明显高于 DGS- COPT。

Objectives To evaluate the field application of fraction from soluble egg antigen (SEA) 107/121 ku used in screening of schistosomiasis. Methods The parallel trials of fraction antigen enzyme linked immunosorbent assay (FA ELISA) with fraction antigen of SEA 107/121 ku, double glue stick circumoval precipitin test(DGS COPT) and fecal hatching test were used in diagnosis of patients before or after chemotherapy, respectively, to evaluate the sensitivity and specificity of the fraction antigen, and observe the correlation of positive rate with each other in the trials. Results The positive rate of fecal positive patients was 92.68% by using the FA ELISA. The false positive rate was 42.25% in the cured patients after chemotherapy for 8-18 months. The negative conversion rates were 36.36%?48.15% and 90.90% after chemotherapy 8, 12 and 18 months, respectively. The serum positive rates were 9.43 % and 21.00% in trials of FA ELISA and the DGS COPT, respectively (χ 2=29.1410, P <0.01). The correlation relationships were found between the positive rate of FA ELISA and that of DGS COPT(r n=0.6263), and between the positive rates of FA ELISA and that of fecal hatching test (r n=0.4324); No correlated relationship were found between the positive rate of DGS COPT and that of fecal hatching(r n=-0.3783). Conclusion The detection result of FA ELISA is closer to that of the fecal hatching test, then the field application value of FA ELISA is much higher than that of DGS COPT.