A组溶血性链球菌膜抗原吸附心肌抗体金标免疫渗滤法的建立

To Establish DIGFA with Membrane Antigen of A Group Hemolytic Streptococcus Adsorbed Myocardial Antibody

目的 建立金标免疫渗滤法(DIGFA)检测A组溶血性链球菌膜抗原吸附心肌抗体(HRA),探讨其对风湿性心脏病诊断的意义。方法 DIGFA检测各组心脏病HRA,阳性血清用膜抗原吸附后再检测HRA。结果 风湿性心脏病患者HRA阳性率53.8％(28/52);原发性心肌病阳性率41.7％(15/36);病毒性心脏病阳性率42.8％(15/35);缺血性心脏病阳性率21.1％(8/38);正常对照组全部阴性。HRA阳性血清经A组溶血性链球菌膜抗原吸附后,风湿性心脏病吸附阳性率75.0％(21/28);原发性心肌病吸附阳性率13.3％(2/15);病毒性心脏病吸附阳性率13.3％(2/15);缺血性心脏病吸附全部阴性。风湿性心脏病膜抗原吸附阳性率显著高于其它组(P<0.01)。结论DIGFA检测A组溶血性链球菌膜抗原吸附HRA,可提高风湿性心脏病诊断的特异性。该法简便、快速、不需要特殊仪器、适合于临床应用。

Objective To establish DIGFA to examine HRA absorbed by membrane antigen of A group hemolytic streptococcus and study the value for diagnosis of rheumatic heart disease using this method. Methods Examined HRA of patients with cardiac disease in different groups using DIGFA, and examined HRA again after membrane antigen adsorbed positive blood serum. Results HRA positive rate of rheumatic heart disease patients was 53. 8% (28/52); HRA positive rate of primary cardiomyopathy was 41. 7%(15/36) ;HRA positive rate of viral cardiopathy was 42. 8% (15/35) ;HRA positive rate of ischemic cardiac disease was 21. l%(8/38) and HRA positive rate of normal contrast group was zero. After A group hemolytic streptococcus absorbed blood serum of HRA,the adsorbing rate of rheumatic heart disease group was 75. 0% (21/28); the adsorbing rate of primary cardiomyopathy was 13. 3%(2/15); the adsorbing rate of viral cardiopathy was13. 3% (2/15) and the adsorbing rate of ischemic cardiac disease was zero. The membrane antigen adsorbing rate of rheumatic heart disease was significantly higher than other groups (P<0. 01). Conclusion The method of using DIGFA to examine HRA absorbed by membrane antigen of A group hemolytic streptococcus can improve the specificity of rheumatic heart disease diagnose. This method is simple,fast ,without special instrument, and suitable for clinical application.