血透患者检测抗HCV IgM的临床意义

为探讨丙型肝炎ＩｇＭ抗体测定在血液透析患者中的临床意义,采秀间接ＥＬＩＳＡ法检测抗ＨＣＶ ＩｇＭ。同时采用ＥＬＩＳＡ测抗ＨＣＶ ＩｇＧ,ＲＴ－ＰＣＲ法测ＨＣＶ ＲＮＡ,并进行比较。结果示６２例血液透析病人中,抗ＨＣＶ ＩｇＭ阳性２７例（４３．６％）,抗ＨＣＶ ＩｇＧ阳性２９例（４６．８％）,ＨＣＶ ＲＮＡ阳性３４例（５４．８％）,任一项阳性３７例（５９．７％）;抗ＨＣＶ ＩｇＭ与ＨＣＶ ＲＮＡ检测     

急慢性丙型肝炎患者抗—HCV—IgM测定临床意义

为了探讨抗－ＨＣＶ－ＩｇＭ抗体在临控ＨＣＶ相关疾病听意义，本文应用ＥＬＩＳＡ间接法检测急、慢性丙型肝炎患者的抗－ＨＣＶ－ＩgM，并同时检测了抗－ＨＣＶ－ＩｇＧ。结果发现在急性、慢性丙肝患者中抗０ＨＣＶ－ＩｇＭ阳性率为９３．３％和８８．９％，抗－ＨＣＶ－ＩｇＧ阳性率为８６．７％和７７．８％。对照组的两各抗体均未检出，结果表明，抗－ＨＣＶ－ＩｇＭ抗体在疾病的早期诊断中的作用优于抗－ＨＣＶ－Ｉdisplay stat     

丙肝患者HCV—IgM免疫复合物的检测及其临床意义

本文报告用ＥＬＩＳＡ法检测丙型肝炎患者ＨＣＶ－ＩｇＭ免疫复合物，并对其与常规肝功能酶谱关系进行了分析，７６例丙型肝炎患者ＨＣＶ－ＩｇＭ免疫复合物检出率为２２．３７％，慢性丙肝患者检出率为３１．９１％，急性患者检出率为６．９０％，两者有显著差异（Ｐ〈０．０５）。     

咳嗽变异性哮喘患儿免疫功能的研究

目的：探讨咳嗽变异性哮喘（ＣＶＡ）的免疫发病机制。方法：采用酶标法、散射比浊法、ＥＬＩＳＡ法、非反向高效液相色谱Ｍｉｌｅｒ改良法以及ＭｃＡｃＡＰＡＡＰ法分别检测ＣＶＡ患儿血清ＩｇＥ、ＩｇＡ、ＩｇＧ、ＩｇＭ、ＩｇＧ亚类,维生素Ａ（ＶＡ）的水平以及Ｔ细胞亚群,并与正常健康儿童对照。结果：ＣＶＡ患儿血清ＩｇＥ增高、ＩｇＡ降低、ＩｇＧ４增高、ＶＡ降低,ＣＤ＋８降低,与对照组相比,差异有极显著意义（Ｐ＜０００１）。结论：ＣＶＡ患儿细胞免疫和体液免疫均有异常。     

应用PCR和ELISA法检测新生儿不同标本中的巨细胞病毒

为了解新生儿感染巨细胞病毒检测方法的可靠性，本文用ＥＬＩＳＡ法筛１８１８例孕妇，查出ＣＭＶ－ＩｇＭ阳性４６例，并以５０例ＣＭＶ－ＩｇＭ阴性作为对照组，在其分娩时用ＰＣＲ检测脐血、新生儿血、新生儿尿中ＣＭＶ－ＤＮＡ，用ＥＬＩＳＡ法测血清ＤＣＭＶ－ＩｇＭ。结果显示对照组两种方法均为阴性，实验组ＥＬＩＳＡ法阳性率５％，ＰＣＲ法阳性率２７％有显著差异。两种方法比较ＰＣＲ法具有高度特异性和敏感性。并提出先天     

病毒性心肌炎血清柯萨奇B组病毒特异性IgM及RNA检测的临床意义

目的：探讨由柯萨奇Ｂ组病毒所致病毒性心肌炎的病原学诊断价值。方法：应用酶联免疫吸附试验及聚合酶链反应对４６例病毒性心肌炎患者血清柯萨奇Ｂ组病毒（ＣＢＶ）特异性ＩｇＭ和ＲＮＡ进行检测。结果：心肌炎组ＣＢＶ－ＩｇＭ检出率为６０．９０％，ＣＢＶ－ＲＮＡ为４３．５％，非心肌炎组分别为２０％和１２％，两组有非常显著的差异。表明ＣＢＶ是病毒性肌炎的主要病原。心肌炎组２周内检测ＣＢＶ－ＩｇＭ和ＣＢＶ－ＲＮＡ的阳性率分别为７８．６％和８５．７％，２～６周分别为４５．２％和２２．６％，其阳性检出率与病程呈负相关。结论：早期检测对于心肌炎的早期诊断及病因学研究具有指导意义     

急性出血性脑血管病并发多脏器功能失常综合征患者血浆？…

目的 探讨血浆内皮素－１（ＥＴ－１）和降钙素基因相关肽（ＣＧＲＰ）在急性出血性脑血管病（ＡＨＣＶＤ）并发多脏器功能失常综合征（ＭＯＤＳ）发病中的作用。方法 采用放射免疫法分别测定２１例ＡＨＣＶＤ合并ＭＯＤＳ患者（ＭＯＤＳ组）、２０例ＡＨＣＶＤ患者（ＡＨＣＶＤ组）及３０例正常人（正常对照组）血浆中ＥＴ－１和ＣＧＲＰ水平。结果：ＭＯＤＳ组及ＡＨＣＶＤ组血浆ＥＴ－１水平明显高于正常对照组（Ｐ均〈０．０１     

逆转录套式ＰＣＲ检测丙型肝炎病毒感染者ＨＣＶ ＲＮＡ

目的　探讨人血清和外周血单个核细胞（ＰＢＭＣ）中丙型肝炎病毒（ＨＣＶ）ＲＮＡ与血清ＩｇＧ和ＩｇＭ抗体联合检测对丙型肝炎的诊断价值。方法对以ＥＬＩＳＡ方法检测所得的４６例ＨＣＶ—ＩｇＧ阳性的标本用逆转录套式聚合酶锭反应（ＲＴ—ＮｅｓｔｅｄＰＣＲ）检测血清和ＰＢＭＣ中ＨＣＶＲＮＡ，同时用ＥＬＩＳＡ方法检测血清中ＨＣＶ—ＩｇＭ。结果血清中有１７例ＨＣＶ　ＲＮＡ阳性和６例ＨＣＶ—ＩｇＭ阳性，而ＰＢＭＣ中有１９例ＨＣＶＲＮＡ阳性。结论血清中ＨＣＶ—ＩｇＭ可作为丙型肝炎的初筛诊断，ＨＣＶ—ＩｇＭ可作为ＨＣＶ近期感染的指标，但二者均不能准确反映病毒在体内的存在情况，而套式ＰＣＲ方法检测ＨＣＶＲＮＡ可直接反映ＨＣＶ在体内的活动情况，其中ＰＢＭＣ中检测ＨＣＶＲＮＡ的阳性率高于血清，提示ＨＣＶ可能在ＰＢＭＣ中潜伏乃至复制。     

急性出血性脑血管病并发多脏器功能失常综合征患者血浆内皮素-1及降钙素基因相关肽水平的观察

目的：探讨血浆内皮素１（ＥＴ１）和降钙素基因相关肽（ＣＧＲＰ）在急性出血性脑血管病（ＡＨＣＶＤ）并发多脏器功能失常综合征（ＭＯＤＳ）发病中的作用。方法：采用放射免疫法分别测定２１例ＡＨＣＶＤ合并ＭＯＤＳ患者（ＭＯＤＳ组）、２０例ＡＨＣＶＤ患者（ＡＨＣＶＤ组）及３０例正常人（正常对照组）血浆中ＥＴ１和ＣＧＲＰ水平。结果：ＭＯＤＳ组及ＡＨＣＶＤ组血浆ＥＴ１水平明显高于正常对照组（Ｐ均＜０．０１），ＭＯＤＳ组ＥＴ１水平又明显高于ＡＨＣＶＤ组（Ｐ＜０．０１）。ＡＨＣＶＤ组血浆ＣＧＲＰ水平高于正常对照组，但无显著性差异（Ｐ＞０．０５）。而ＭＯＤＳ组血浆ＣＧＲＰ水平明显低于正常对照组，ＥＴ１／ＣＧＲＰ（Ｅ／Ｃ）比值明显高于ＡＨＣＶＤ组及正常对照组（Ｐ均＜０．０１）。结论：血浆ＥＴ１水平升高、ＣＧＲＰ水平降低、Ｅ／Ｃ比值严重失衡与ＭＯＤＳ的发生相关；检测血浆ＥＴ１和ＣＧＲＰ水平对评估ＡＨＣＶＤ患者预后有一定意义     

经胸和多平面经食道超声心动图定量诊断主动脉瓣狭窄

为评价多平面经食道超声心动图（ＭＴＥＥ）定量诊断主动脉瓣狭窄（ＡＳ）的可行性和可靠性，在３２例成年ＡＳ患者中应用经胸超声心动图（ＴＴＥ）测量了主动脉瓣的瓣口面积（ＡＶＡ－ＴＴＥ），最大瞬时压差（ＰＰＧ）和平均压差（ＭＰＧ），应用ＭＴＥＥ测量了瓣口面积（ＡＶＡ－ＴＥＥ），并对手术治疗的患者直接测量了其瓣口面积（ＡＶＡ－ＯＰＥ）。结果显示：①ＡＶＡ－ＴＥＥ与ＡＶＡ－ＴＴＥ、ＡＶＡ－ＴＥＥ与ＡＶＡ－ＯＰＥ以及ＡＶＡ－ＴＴＥ与ＡＶＡ－ＯＰＥ间均高度相关（ｒ分别为０．９１、０．９４、０．９１），ＡＶＡ－ＴＴＥ显著高估ＡＶＡ－ＯＰＥ（Ｐ值＜０．０５）；②ＭＴＥＥ对预测重度ＡＳ（ＡＶＡ≤０．７５ｃｍ２）的敏感性和特异性均为１００％；③ＰＰＧ、ＭＰＧ与ＡＶＡ－ＴＴＥ和ＡＶＡ－ＴＥＥ间仅呈中度负相关（ｒ＝－０．７３～－０．７６），而与ＡＶＡ－ＯＶＥ间无相关关系。表明对于ＡＳ的定量诊断，ＭＴＥＥ具有高度的可行性和可靠性，而跨瓣压差存在明显的限制性。     

良性淋巴组织增生患者外周血EB病毒标志物的检测及临床意义

目的 了解成人良性淋巴组织增生性患者中EB病毒（Epstein-Barr virus,EBV）感染状态,探讨成人淋巴组织增生患者外周血EBV标志物检测的临床意义.方法 应用酶联免疫吸附法（ELISA）检测40例成人反应性淋巴组织增生性疾病患者和44例正常对照血清EBV衣壳抗原（viral capsid antigen,VCA）特异性IgM、IgG抗体以及EBV早期抗原（early antigen, EA）IgG抗体;同时应用实时荧光定量PCR技术检测其外周血单核细胞EBV DNA载量.结果 40例淋巴组织增生患者血清标本中VCA-IgG、VCA-IgM和EA-IgG抗体的检出率分别为95.0%（38/40）、7.5%（3/40）和32.5%（13//40）,44例健康对照3种抗体的检出率分别为97.7%（43/44）、2.3%（1/44）和2.3%（1//44）,统计学分析表明两组间VCA-IgG和VCA-IgM的检出率无显著性差异,而淋巴组织增生组EA-IgG抗体的检出率显著高于正常对照组（x2=13.784,P=0.0002）.淋巴组织增生组病毒载量高于健康对照,差异有显著性（z=2.655,P=0.008）,EA-IgG抗体阳性患者外周血中EBV载量高于EA-IgG抗体阴性患者,差异亦有显著性（z=2.025,P=0.043）.结论 成人良性淋巴组织增生性疾病中存在EBV激活感染,病人外周血EBV标志物检测有助于明确临床诊断,进行合理治疗.     

338例 EB病毒五项抗体与白细胞检测结果的研究分析

目的： EB病毒五项抗体与白细胞检测结果的相互关系。方法使用酶联免疫吸附试验（ELISA ）检测EB病毒五项抗体、阻抗法检测白细胞计数和分类,回顾性分析338例EB病毒五项抗体与白细胞检测的结果,采用SPSS11．5对检验数据进行χ2检验、t检验进行分析。结果 EB病毒抗体五项结果全部“阴性”的、EB病毒抗原（VCA）‐IgG抗体、EB病毒核抗原（EBNA1） IgG抗体二者“阳性”的;EB病毒抗原（VCA）‐IgG抗体、EB病毒早期抗原（EA）IgG抗体、EB病毒核抗原（EBNA1）IgG抗体三者“阳性”的白细胞计数和分类结果均在各自生物参考区间范围之内;EB病毒抗原（VCA ）‐IgA抗体、EB病毒抗原（VCA ）IgM 抗体、EB病毒早期抗原（EA）IgG抗体、EB病毒核抗原（EBNA1）IgG抗体四者“阳性”的白细胞计数和分类均在各自生物参考区间范围下限;EB病毒抗原（VCA ）IgM抗体“阳性”的白细胞计数低于生物参考区间范围下限。白细胞分类中淋巴细胞分类结果增高,中性粒细胞分类结果在生物参考区间上限,其余三类结果正常。结论 EB病毒五项抗体与白细胞检测结果有一定的相关性,有助于EB V感染的早期诊断,联合检测两类指标可提高EB V现症感染的检出率。     

VCA+EA多肽片段联合包被ELISA对血液EBV IgA检测效果的研究

目的探讨中山大学附属肿瘤医院研制的病毒壳抗原(VCA)+早期抗原(EA)多肽片段联合包被聚苯乙烯微孔板酶联免疫吸附测定(ELISA)方法对血液中Epstein-Barr病毒(EBV)免疫球蛋白A(IgA)的检测效果,并将其与进口筛选试剂盒进行比较,最终对VCA+EA多肽片段联合包被ELISA试剂盒性能进行评价。方法收集鼻咽癌患者血清86例,健康人群血清100例,用ELISA检测血清中IgA的OD值,观察该方法的最低检测限、线性范围、精密度、回收率,同时采用进口的Epstein-Barr病毒持续表达核抗原(EBNA1)+VCA-p18抗原包被ELISA方法进行检测,观察其临床性能。结果 VCA+EA多肽片段联合包被ELISA方法最低检测限为(0.003 4±0.002 6),血清稀释100倍数(及以上),其水平与吸光度呈线性关系,阴性标本、弱阳性标本、阳性标本IgA水平的日内变异系数为3.97%、9.76%、9.23%,日间变异变异系数分别为7.56%、10.20%、7.67%。VCA+EA多肽片段联合包被试剂盒与EBNA1+VCA-p18抗原包被试剂盒比较,相关系数为0.926 6;检测鼻咽癌敏感性为88.90%,特异性为77.80%,阳性预测值为80.00%,阴性预测值为87.50%。结论 VCA+EA多肽片段联合检测鼻咽癌有较高敏感性,重复性较好,阴性结果预测较可靠,可作为临床筛查鼻咽癌的新方法。     

Real-time Epstein-Barr virus PCR for the diagnosis of primary EBV infections and EBV reactivation.

BACKGROUND: The serological diagnosis of primary Epstein-Barr virus (EBV) infections is often difficult, whereas the relevance of elevated immunoglobulin G (IgG) antibodies against early antigen (EA) for the diagnosis of EBV reactivation has increasingly become a matter of dispute. Recently, EBV PCR has been added as a diagnostic tool. Positive EBV PCR has been demonstrated in the serum of patients with primary EBV infections and EBV reactivation. OBJECTIVES: To compare classical serological diagnosis of primary EBV infection and EBV reactivation with real-time EBV PCR. STUDY DESIGN: Sera from 45 patients were selected with detectable immunoglobulin M (IgM) antibodies against EBV viral capsid antigen (VCA), and 62 sera were selected with a reactivation profile. A real-time EBV PCR was performed with DNA extracted from these sera. RESULTS: Based on serological data, the diagnosis of primary EBV infection was established for 24 of the 45 IgM VCA-positive patients. By performing PCR, seven extra cases of primary infection were diagnosed for which no heterophilic antibodies could be detected. In five cases of primary infection, no EBV DNA could be detected by PCR. Only in two of the 62 sera with a reactivation seroprofile could EBV DNA be detected. CONCLUSIONS: Based on these data, we suggest that for the diagnosis of primary infections, EBV PCR could lead to an increase of >16% in the number of positive diagnoses by confirming a positive IgM VCA in the absence of heterophilic antibodies. Furthermore, EBV PCR is positive in only 3% of sera with elevated antibodies against EA, raising doubt as to the utility of EA titers for diagnosing EBV reactivation.     

基因重组EB病毒gp125抗原的鼻咽癌免疫荧光血清学诊断方法

目的　尝试用基因工程表达抗原建立鼻咽癌诊断血清学方法。方法　用重组痘苗病毒感染细胞为抗原片 ,用免疫荧光法检测鼻咽癌患者、其他肿瘤患者和正常人血清抗Epstein Barr病毒 (EBV)IgA/gp12 5抗体 ,同时用传统方法检测其IgA/VCA、IgA/EA和IgA/MA抗体 ,将所得结果进行比较。结果　其灵敏度远远高于IgA/EA ,接近于IgA/MA和IgA/VCA ,特异性高于IgA/MA和IgA/VCA ,接近于IgA/EA。结论　建立了一种可用于鼻咽癌的诊断和高发人群普查的灵敏、特异、经济、简便的方法     

Diagnosis of EBV infection by means of ELISA

Ten commercial test kits with different antigens in respect of type viral capsid antigen (VCA), Epstein Barr nuclear antigen complex (EBNA), early antigen (EA) and source (recombinant, cell derived) for detection of IgM and IgG antibodies against Epstein Barr virus (EBV) were compared with standard immunofluorescence tests. The products tested differed widely in respect of sensitivity and specificity. As the result of our study we concluded that for determination of IgM antibodies (recent infection) tests with VCA extracted from cultured cells should be preferred, while past infection is indicated best by the presence of EBNA antibodies. Both tests may be complemented by determination of IgG antibodies against the early antigen.     

妊娠高血压综合征患者血清体液免疫指标分析

目的：分析妊娠高血压综合征患者的体液免疫状况.方法：对比研究55例妊娠高血压综合征患者（妊高征组）及30例正常孕晚期妇女（对照组）的C3,C4,IgA,IgG及IgM.结果：与对照组相比,实验组患者C3,C4,IgA,IgG及IgM水平均降低,重度妊娠高血压综合征患者尤为显著.结论：对妊娠高血压综合征患者进行C3,C4,IgA,IgG及IgM的检测,有利于及早发现并监测病情的严重程度.     

Evaluation of the diagnostic value of measuring IgG,IgM, and IgA antibodies to mycobacterial A60 antigen in active tuberculosis

The purpose of the present study was to evaluate the clinical usefulness of detection of serum immunoglobulin A (IgA), IgG, and IgM antibodies raised against the mycobacterial A60 antigen for the diagnosis and discrimination of active tuberculosis (TB) from other pulmonary diseases. Three commercially available ELISA kits (IgA, IgG, and IgM) (ANDA Biologicals, Strasbourg, France) were evaluated simultaneously in 246 serum samples from 3 groups of patients: group I, 171 patients with active TB (128 pulmonary TB and 43 extrapulmonary TB); group II, 73 patients with pulmonary non-TB diseases; and group III, 2 leprosies patients. The sensitivities of tests ranged from 31.3% (IgA) to 94% (IgG) in pulmonary TB patients and from 21% (IgA) to 84% (IgG) in extrapulmonary TB patients. The specificities of assays varied from 92% (IgG) to 96% (IgA) in the pulmonary non-TB group. Combination of IgG with IgA and/or IgM does not improve its sensitivity. Clinical use of the A60-based serodiagnostic IgG assay is of great value for the rapid diagnosis and discrimination between active TB and pulmonary non-TB diseases. Moreover, this test could be used to increase diagnostic accuracy, especially for smear-negative TB cases, which are difficult to diagnose.     

轮状病毒肠炎患儿异型淋巴细胞和免疫球蛋白水平的变化探析

目的观察治疗前、后轮状病毒(RV)肠炎患儿的异型淋巴细胞的数量和免疫球蛋白的水平变化并分析其临床意义。方法分别对100例RV肠炎患儿(A组)和60例健康小儿(B组)治疗前、后的血常规、异型淋巴细胞的数量以及血清免疫球蛋白的水平进行检测,并统计分析。结果在治疗前A组患儿的外周血异型淋巴细胞显著高于B组(P0.05),A组患儿的血清免疫球蛋白Ig A、Ig M以及Ig G水平明显下降。在治疗后A组患儿的外周血异型淋巴细胞低于治疗前(P0.05),同时血清免疫球蛋白Ig A、Ig M、Ig G的水平明显上升。结论 RV肠炎患儿在治疗前、后进行异型淋巴细胞及免疫球蛋白的检测有助于对病毒感染的判断及了解患儿的机体免疫功能状态和对疾病治疗的有效性,对轮状病毒肠炎患儿的治疗有指导意义。     

Improved accuracy of detection of nasopharyngeal carcinoma by combined application of circulating Epstein-Barr virus DNA and anti-Epstein-Barr viral capsid antigen IgA antibody

BACKGROUND: Circulating Epstein-Barr viral (EBV) DNA and anti-EBV capsid antigen IgA (IgA VCA) represent two of the most sensitive peripheral blood markers of nasopharyngeal carcinoma (NPC), but direct comparative studies of these two markers are lacking. METHODS: The sensitivities and specificities of IgA-VCA and EBV DNA for diagnosis of NPC were determined in 139 new cases of NPC and 178 healthy individuals, respectively. EBV DNA was also assessed in 36 healthy family members identified as having false-positive IgA-VCA results at a screening clinic. EBV DNA was measured by a real-time quantitative PCR assay with a detection limit of 60 copies/mL. IgA-VCA was measured by semiquantitative indirect immunofluorescent method; a titer > or =1/10 was taken as positive. RESULTS: The sensitivities of EBV DNA and IgA-VCA for diagnosis of NPC were 95% (95% confidence interval, 91-98%) and 81% (73-87%), respectively. The combined marker panel had an overall sensitivity (positive result by either marker) of 99%. The concentrations of both markers showed dependence on cancer stage. The specificities of EBV DNA and IgA-VCA were 98% (96-99%) and 96% (91-98%), respectively. Among 36 healthy family members with false-positive IgA-VCA results, three-fourths had undetectable EBV DNA, whereas the others had increased EBV DNA concentrations that were significantly lower than in NPC patients. CONCLUSIONS: For diagnosis of NPC, EBV DNA identifies almost all false-negative IgA-VCA cases and gives a 99% diagnostic sensitivity when combined with IgA-VCA. In the screening setting, EBV DNA identifies three-fourths of false-positive IgA-VCA cases. The selective application of EBV DNA in an IgA-VCA-based screening protocol could improve screening accuracy with only moderate increases in cost.