CAJ | 학술논문

目的：探讨丝虫特异IgG4酶联免疫吸附测定试验（ELISA）检测试剂盒检测丝虫病患者血清和滤纸血中特异IgG4亚类抗体的敏感度和特异度并评价其应用价值。方法应用丝虫特异IgG4 ELISA检测试剂盒，检测微丝蚴阳性患者血清或滤纸血、其他蠕虫患者血清、晚期丝虫病患者滤纸血、原微丝蚴血症转阴者滤纸血和基本消除丝虫病后出生儿童滤纸血以及消除丝虫病后不同时间居民血清或滤纸血样本。采用两相关样本的非参数检验，分析血清与滤纸血检测相同稀释度下的IgG4的A值差异。结果检测86例微丝蚴阳性患者血清，显示丝虫特异IgG4阳性81例，阳性符合率94．19％。检测97份其他蠕虫患者血清、58份阴性冻存血清和100份正常健康人对照血清，显示丝虫特异IgG4全部阴性，阴性符合率100％。4例现症微丝蚴血症患者，血清和滤纸血丝虫特异IgG4全部阳性，血清阳性吸光度（A）值均高于同一患者滤纸血样本 A 值，但差异无统计学意义（Z＝-1．826，P＞0．05）。检测48例晚期丝虫病患者滤纸血、76例原微丝蚴血症转阴者滤纸血、312例基本消除丝虫病地区1983年后出生儿童滤纸血，显示丝虫特异IgG4全部阴性。检测原丝虫病高中度流行地区消除丝虫病后的枣庄、泰安和济宁地市居民滤纸血和血清样本分别为2744份、2243份和800份，显示丝虫特异IgG4全部阴性。结论丝虫特异IgG4酶联免疫吸附测定试验的检测试剂盒敏感度高、特异度强、操作简便快捷，特别适用于丝虫病诊断和消除丝虫病地区的疾病监测。
목적：탐토사충특이IgG4매련면역흡부측정시험（ELISA）검측시제합검측사충병환자혈청화려지혈중특이IgG4아류항체적민감도화특이도병평개기응용개치。방법응용사충특이IgG4 ELISA검측시제합，검측미사유양성환자혈청혹려지혈、기타연충환자혈청、만기사충병환자려지혈、원미사유혈증전음자려지혈화기본소제사충병후출생인동려지혈이급소제사충병후불동시간거민혈청혹려지혈양본。채용량상관양본적비삼수검험，분석혈청여려지혈검측상동희석도하적IgG4적A치차이。결과검측86례미사유양성환자혈청，현시사충특이IgG4양성81례，양성부합솔94．19％。검측97빈기타연충환자혈청、58빈음성동존혈청화100빈정상건강인대조혈청，현시사충특이IgG4전부음성，음성부합솔100％。4례현증미사유혈증환자，혈청화려지혈사충특이IgG4전부양성，혈청양성흡광도（A）치균고우동일환자려지혈양본 A 치，단차이무통계학의의（Z＝-1．826，P＞0．05）。검측48례만기사충병환자려지혈、76례원미사유혈증전음자려지혈、312례기본소제사충병지구1983년후출생인동려지혈，현시사충특이IgG4전부음성。검측원사충병고중도류행지구소제사충병후적조장、태안화제저지시거민려지혈화혈청양본분별위2744빈、2243빈화800빈，현시사충특이IgG4전부음성。결론사충특이IgG4매련면역흡부측정시험적검측시제합민감도고、특이도강、조작간편쾌첩，특별괄용우사충병진단화소제사충병지구적질병감측。
Objective To investigate the sensitivity and specificity of ELISA in detecting lymphatic filariasis patients and evaluate the application value.Methods Using double-blind assay,microfilaria positive patients′serum,serum of patients with other worms,advanced filariasis patients′filter paper blood, primary hyperlipidemia microfilaria and the elimination of filariasis patients filter paper blood were detected by filarial specific IgG4 ELISA test kits.Results Eighty-six serum of microfilaria positive patients in total. The results of filarial specific IgG4 ELISA was eighty-one cases,the coincidence rate was 94.19%(81/86). Four patients′of serum and filter were specific IgG4 positive,the antibody level of serum-positive patients was higher than that of paper blood positive patients′.Seropositive patients′OD values were higher than that of filter paper blood positive patients′,there was no significant difference (Z=-1.826,P>0.05).Serum of ninety-seven patients with other worms,filter paper blood of fourty-eight advanced filariasis patients and filter paper blood of seventy-six microfilaria positive patients who had turnd negative were negative. Furthermore,filter paper bood of three hundred and twelve children who were born in filariasis elimination areas after 1983,and eight hundred cases of three high endemic area were detected negative.Filter paper blood and serum samples in Zaozhuang,Jining,Tai′an where former high degree detections of endemic filariasis elimination were 2 744 copies,2 243 copies and 800 copies separately,all samples were negative. Conclusions The filarial specific IgG4 kit is high sensitivity and specificity.The ELISA is suitable for diagnosis and evaluation of filariasis in endemic region,and the filarial specific IgG4 ELISA test kit is simple,fast,and easy to judge the results.