CAJ | 학술논문

目的：探索甲型副伤寒沙门菌（SPA）人群本底、恢复期病人及携带者脂多糖特异性抗体（LPS IgG）血清抗体水平，为使用LPS IgG抗体筛查方法鉴别甲型副伤寒携带者提供经验。方法在桂林等7个市、县筛选出440名有明确甲型副伤寒发病史的研究对象，采集其血液标本及粪便标本，使用ELISA方法检测血清LPS IgG抗体滴度，对粪便标本进行SPA分离培养。把血清抗体结果与粪便SPA分离培养结果进行比较，了解不同特征对象的LPS IgG抗体水平。结果共完成353名研究对象的随访，通过两轮粪便采集从7名对象中分离出SPA，其中6名为SPA携带者，1名为SPA慢性携带者。SPA阴性和阳性对象LPS IgG平均抗体滴度分别为15.8 EU和103.5 EU，SPA阳性对象LPS IgG平均抗体滴度高于阴性对象，差异有统计学意义（P=0.000）。以LPS IgG抗体滴度≥35 EU作为阈值来筛查SPA阳性对象的灵敏度和特异度分别为86%和89%。结论 SPA携带者的LPS IgG血清抗体水平远高于非携带者。通过LPS抗体检测能有效筛查出SPA携带者。
목적：탐색갑형부상한사문균（SPA）인군본저、회복기병인급휴대자지다당특이성항체（LPS IgG）혈청항체수평，위사용LPS IgG항체사사방법감별갑형부상한휴대자제공경험。방법재계림등7개시、현사선출440명유명학갑형부상한발병사적연구대상，채집기혈액표본급분편표본，사용ELISA방법검측혈청LPS IgG항체적도，대분편표본진행SPA분리배양。파혈청항체결과여분편SPA분리배양결과진행비교，료해불동특정대상적LPS IgG항체수평。결과공완성353명연구대상적수방，통과량륜분편채집종7명대상중분리출SPA，기중6명위SPA휴대자，1명위SPA만성휴대자。SPA음성화양성대상LPS IgG평균항체적도분별위15.8 EU화103.5 EU，SPA양성대상LPS IgG평균항체적도고우음성대상，차이유통계학의의（P=0.000）。이LPS IgG항체적도≥35 EU작위역치래사사SPA양성대상적령민도화특이도분별위86%화89%。결론 SPA휴대자적LPS IgG혈청항체수평원고우비휴대자。통과LPS항체검측능유효사사출SPA휴대자。
Objective To determine the average titre of anti-LPS (Lipopolysaccharide) IgG in native persons, historical SPA patients and paratyphoid A carriers and to determine the utility of screening with anti-LPS antibodies to identify paratyphoid carriers. Methods 440 target persons who have had an acute paratyphoid A fever episode confirmed by bacterial culture in the last 10 years were identified from 7 cities in Guangxi. Each subject was asked to provide blood and stool samples. Stool samples were performed by culture to isolate SPA and blood samples were performed by ELISA test to get anti-LPS IgG titre. The results of stool culture and ELISA test were compared to determine anti -LPS IgG titre between different groups.Results Among 353 target persons followed up 7 SPA strains were isolated from the stool samples which were collected in two rounds. Of them 6 target persons were identified as shedder and one as chronic carrier according to this study definition. The average IgG Anti-LPS antibody titre of stool culture negative group and positive group was 15.8EU and103.5EU respectively. The average titre of anti-LPS IgG of culture positive was significant higher than that culture negative. Anti-LPS antibody titers≥35EU had a 86%sensitivity and 89% specificity for detecting stool culture positive. Conclusion The anti-LPS IgG of SPA carrier was far higher than non-SPA carrier. It was able to detect SPA carrier effectively by ELISA anti-LPS IgG screening test.