中国寄生虫学与寄生虫病杂志 ›› 2005, Vol. 23 ›› Issue (2): 7-92.

• 论著 • 上一篇    下一篇

全血金标免疫渗滤法快速检测棘球蚴病的现场应用

陈新华1;温浩2;张朝霞3;冯晓辉2;张静萍2;张金辉2;马旭东2;郑树森1   

  1. 1 浙江大学医学院附属第一医院肝胆胰外科, 杭州 310031;2 新疆维吾尔自治区包虫病临床研究所,新疆包虫病基础医学重点实验室, 乌鲁木齐 830054;3 新疆维吾尔自治区临床检验中心, 乌鲁木齐 830000
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2005-04-30 发布日期:2005-04-30
  • 通讯作者: 温浩

Field Trial on Rapid Detection of Echinococcosis by Dot Immunogold Filtration Assay (DIGFA) with Whole Blood Sample

CHEN Xin-hua;WEN Hao;ZHANG Zhao-xia; FENG Xiao-hui;ZHANG Jing-ping;
ZHANG Jin-hui;MA Xu-dong;ZHENG Shu-seng
  

  1. Surgical Lab, The First Affiliated Hospital, Medical School, Zhejiang University, Hangzhou 310031, China
  • Received:1900-01-01 Revised:1900-01-01 Online:2005-04-30 Published:2005-04-30
  • Contact: WEN Hao

摘要: 目的?摇建立一种检测全血标本的棘球蚴病现场快速诊断方法。 方法 制备检测棘球蚴病抗体的全血金标免疫渗滤法(DIGFA)快速诊断试剂盒,以土豆凝集素与全血混合达到快速凝血的目的,并对1 678名流行区健康体检者、38例棘球蚴病患者、52名非流行区健康体检者、40例其他肝肺占位患者做棘球蚴病全血现场诊断试验,评价其作为初筛棘球蚴病普查手段的实际应用价值。 结果 全血DIGFA对1 678份流行区体检者阳性检出率为8.46%,其中肝脏B超及胸部透视阳性检出率为3.04%,对比免疫学检查142例阳性结果和影像学检查51例阳性结果:影像学检查阳性51例中有43例全血DIGFA为阳性,对其余8例影像学检查阳性而全血DIGFA阴性体检者进行16个月随访,经CT检查或病理学检查证实为肝棘球蚴坏死(3例)、肝钙化(2例)、肝囊肿(2例)、肝癌(1例)。而免疫学检查阳性的142例体检者中43例B超为阳性,对其余99例全血DIGFA阳性而影像学检查阴性的体检者进行16个月随访,发现肺部棘球蚴3例(随访仍在继续,数据统计截止到2003年6月)。对临床手术和病理检查确诊的38例棘球蚴病患者的阳性检出率为89.5%,对52份非流行区无狗羊接触史的健康体检者全血血样阳性检出率为0,与40例其他非棘球蚴性肝肺占位疾病(肝囊肿10例、肝血管瘤10例、肝癌10例、肺结核6例、肺癌4例)全血血样无交叉反应。随机抽取各组全血标本190例分别提取全血和血清标本,进行全血DIGFA、血清DIGFA和血清ELISA单盲法检测,三者检测结果差异无显著性(P>0.05)。 结论 棘球蚴病全血快速诊断试剂盒操作简便和快速,适合普查和流行病学调查。

关键词: 金标免疫渗滤法, 棘球蚴病, 全血标本, 现场试验

Abstract: Objective To establish a rapid, simple and reliable assay with samples of whole blood for diagnosis and epidemiological study on hydatidosis. Methods The dot immunogold filtration assay kit was developed and potato agglutinin was applied to blot blood quickly. Results Among 1 678 persons from prevalent area, the positive rate of DIGFA was 8.46% while that of image examination was 3.04%. Both DIGFA and image technique showed positive results in 43 cases. 8 cases with positive image but negative DIGFA were followed up for 16 months, which turned out that 3 cases with necrotic hydatid cysts, 2 cases with calcified hydatid cysts and 2 cases with benign hepatic cysts. 99 cases with positive DIGFA but negative image were also followed up for 16 months, 3 pulmonary hydatid cases were confirmed. Among 38 cases proved by operation and histopathology, the positive rate of DIGFA was 89.5%. 52 samples from non-prevalent area all showed negative DIGFA. Another 40 non-hydatidosis cases (10 samples of hepatic hemangioma, 10 of non-parasitic cysts of liver, 10 of primary hepatic carcinoma, 6 of pulmonary tuberculosis, 4 of lung cancer) also showed negative DIGFA. 190 samples were selected randomly and detected blindly by DIGFA with whole blood, DIGFA with serum and ELISA with serum to evaluate their diagnostic effect with no statistical difference(P>0.05). Conclusion The DIGFA kit is rapid, simple and reliable in epidemiological study of hydatid disease, with an advantage of using whole blood sample instead of serum.

Key words: Dot immunogold filtration assay, Hydatidosis, Whole blood sample, Field trial