疟原虫的形态学及快速免疫诊断研究与临床应用

COMPARATION RESEARCH AND CLINICAL APPLICATION OF MORPHOLOGICAL EXAMINATION AND IMMUNOLOGICAL RAPID DETECTION TEST FOR MALARIA

疟疾的实验室诊断对于临床治疗至关重要,诊断失误会造成患者误诊、漏诊甚至死亡。血涂片的染色镜检是疟疾实验室诊断的金标准。本研究旨在对感染人体的4种疟原虫:恶性疟原虫P.falciparum、间日疟原虫P.vivax、以及卵形疟原虫P.ovale和三日疟原虫P.malaiae在红细胞中的各期形态进行系统梳理,以提高形态诊断过程中的准确率。本文对2018年疑似疟疾样本的快速检测试剂条(RDT)和镜检形态学检测结果进行比较。结果发现,虽然RDT检测快速、易于操作,但镜检仍然是疟疾确诊的金标准。同时定期形态学培训及质控考核应该成为疟疾检测实验室的常规工作。

Accurate clinical diagnosis and therapy of malaria depends much on the results from laboratory examination.Traditional morphological examinations under light microscopes in thin blood smear stained with Giemsa were considered as gold standard in clinical diagnosis.In the present paper,the morphologic characters of P.falciparum,P.vivax,P.ovale and P.malaiae in red blood cells at different stages were reviewed and total of 648 clinical specimens collected in 2018 were utilized to analysis the application feasibility of rapid diagnosis test stripe(RDT)for clinical diagnosis.Results obtained suggested that although simple,rapid and easily operate,RDT was shown with prominent limitations for the detection of P.ovale and P.malaiae infections and the sensitivity and specificity of RDT should be improved before it was used in clinical diagnosis.The quality of clinical diagnosis for malaria should be also improved with more skilled staffs.