检测特异IgG4对脑囊虫病诊断与疗效考核的研究

Determination of specific IgG4 for diagnosis and therapeutic evaluation of cerebral cysticercosis

目的 探讨检测患者血清特异IgG4对脑囊虫病诊断和疗效考核的价值. 方法 应用胶体金标记的抗人 IgG4 McAb为探针检测脑囊虫患者血清中的特异IgG4,并与其脑CT影像表现进行对比分析.结果 检测脑囊虫病患者血清特异IgG4阳性率为97.8%,除肝包虫病人血清出现弱交叉反应外,其它寄生虫病、中枢神经系统疾病和健康对照均为阴性;检测不同疗程脑囊虫病患者血清特异IgG4,发现随着疗程的增加,临床症状的好转,患者血清特异IgG4逐渐降低或消失,并且脑囊虫病患者血清特异IgG4的阳性率和阳性强度与囊尾蚴在脑组织内寄生的数量,以及存活、崩解、死亡、钙化等病理变化相一致, 可客观地反映囊尾蚴在脑组织内的存活状态.结论 检测患者血清特异IgG4对脑囊虫病诊断和疗效考核具有较好的应用价值.

OBJECTIVE: To probe the significance of specific IgG4 in sera of patients with cerebral cysticercosis for diagnosis and therapeutic evaluation. METHODS: Specific IgG4 in sera of patients with cerebral cysticercosis was assessed using colloidal gold-labeled mouse-anti-human IgG4 McAb as probe. The results were compared with the CT image manifestation. RESULTS: The specific IgG4 positive rate in sera of patients with cerebral cysticercosis was 97.8%, whereas sera from patients with other kinds of parasitosis or central nerve system disease and the control group were all negative, except for a weak cross-reaction of sera from patients with hepatic echinococoosis. The determination of specific IgG4 in sera of patients with cerebral cysticercosis during different times of treatment showed that along with an increase in treatment time and improvement of clinical symptoms, specific IgG4 level gradually decreased. The positive rate and intensity of specific IgG4 in sera from patients with cerebral cysticercosis were consistent with the number of cysticercus parasites in the brain and pathologic changes, such as survival, disintegration, death and calcification. Survival of cysticercus in the brain was objectively evaluated using this technique. CONCLUSIONS: The determination of specific IgG4 in sera is a practical method for diagnosis and therapeutic evaluation of cerebral cysticercosis.