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1.
目的:探讨不同莱姆病诊断技术的灵敏度和特异度。方法:应用间接免疫荧光抗体法(IFA)、酶联免疫吸附试验(ELISA)、蛋白印迹法(WB)3种方法检测新疆123例疑似莱姆病患者血清及部分脑脊液抗伯氏疏螺旋体IgM、IgG抗体,其中3例PCR法检测尿液,结合相应的影像学、电生理检查诊断莱姆病。似然比方法计算灵敏度。结果:依据中国疾病控制中心制定的标准确诊莱姆病43例。其神经系统、皮肤损害、关节炎发生率分别为31·7%(39/123),1·62%(2/123),1·62%(2/123)。IFA、ELISA、和WB3种检验方法的阳性率分别为60·47%、48·84%、39·53%。用似然比方法计算灵敏度:IFA为60·47%、ELISA为48·84%、WB为39·53%;联合灵敏度为79·60%;特异度均为100%。3例PCR均阳性。结论:应用IFA、ELISA和WB技术检测血清和脑脊液抗伯氏疏螺旋体抗体有助于临床诊断。  相似文献   

2.
目的:评估聚合酶链反应(PCR)检测莱姆病患者尿液中伯氏疏螺旋体DNA的诊断价值。方法:2004至2006年来自新疆莱姆病自然疫源地临床疑似莱姆病患者17例(均有蜱暴露史和莱姆病临床证据者)和6例以前确诊并治疗后完全恢复的莱姆病患者,共23例为病例组;另选择25例非疑似莱姆病患者为对照组。应用PCR方法检测尿液中伯氏疏螺旋体DNA,采用间接免疫荧光(IFA)检测血清伯氏疏螺旋体抗体。结果:①17例莱姆病患者临床表现呈多系统损害。12/17例(70.59%)为神经型(周围神经病3例,其中1例合并下肢瘀积性皮炎;游走性红斑并发莱姆脑病2例;脑膜脑炎2例;脑炎2例;脑膜炎、脑干炎和脊髓炎各1例);流感样症状2例,其中伴皮疹1例;余心脏型、精神障碍和肝病型各1例。②PCR伯氏疏螺旋体DNA检测阳性17/17例(总阳性率100%)。4例血清IFA试验伯氏疏螺旋体抗体阳性。以前确诊并治疗者6例及对照组25例尿PCR伯氏疏螺旋体DNA和血清IFA试验伯氏疏螺旋体抗体均阴性。③10例完成抗生素治疗后3个月复查,9例PCR伯氏疏螺旋体DNA检测阴性(包括3例晚期莱姆病患者),1例2年复查时仍阳性;4例血清伯氏疏螺旋体抗体阳性者复查均阴性。④早期莱姆病多采用几周的抗生素治疗方案。结论:PCR检测尿液中伯氏疏螺旋体DNA是莱姆病一个有价值的诊断工具。  相似文献   

3.
目的 :探讨血管性帕金森综合征患者血清ACLA的变化及其在发病中的意义。方法 :采用ELISA法检测 42例VP ,3 5例PD ,3 0例MCI及 3 0例正常对照组血清ACLA变化并对照分析。结果 :①VP与MCI组ACLA的IgG与IgM阳性率明显高于PD与正常对照组 (P <0 0 5 ) ;②VP组ACLA的IgG阳性率明显高于IgM(P <0 0 5 ) ;③运动障碍重 ,伴痴呆的VP患者ACLA之IgG阳性率明显增高(P <0 0 5 )。结论 :IgG型ACLA可能作为致病性抗体参与VP的发病过程  相似文献   

4.
格林-巴利综合征患者的GM1抗体与空肠弯曲菌感染的关系   总被引:5,自引:0,他引:5  
目的 检测GBS患者血清中的GM1抗体 ,并且观察其与CJ抗体的关系 ,以试图发现CJ是否是通过GM 1样结构致敏导致GBS的发生。方法 用间接ELISA法在 81例GBS患者、34例其他神经疾病患者 (OND)和 6 3例正常对照 (NC)的血清测定了CJ抗体和GM 1抗体。结果 GBS组IgM型抗体和IgG型抗体的阳性率分别为 30 .9%和 34.6 % ,与OND组和NC组差异均有显著性。在IgM型GM 1抗体阳性的GBS患者 6 8%有CJ近期感染 ,IgG型GM1抗体阳性的患者 5 3.6 %有CJ近期感染。IgM型GM 1抗体与IgM型CJ抗体和CJ近期感染有关 ,而IgG型GM1抗体与IgG型CJ抗体和CJ近期感染无关。结论 IgM型GM 1抗体与CJ近期感染有关 ,而IgG型GM 1抗体与CJ近期感染无关。CJ感染后可通过GM1样结构发生交叉反应导致神经组织结构和功能的改变 ,但并非所有GM1抗体均为CJ感染引起的  相似文献   

5.
目的 探讨脑出血与幽门螺旋杆菌(HP)感染的发病关系及其作用机制。方法 用HP特异抗体试剂盒测定脑出血患者60例及健康查体正常对照组30例,HP特异抗体(IgG、IgA、IgM)阳性率。结果 脑出血组血清HP抗体IgG阳性率52%(31例),IgA28%(17例),IgM15%(9例)。对照组HPIgG阳性率27%(8例),IgA13%(4例),IgM6%(2例)。两组比较P<0.01,有统计意义。同组比较HP IgG发生率最高,HP IgA次之,HP IgM最低。急性期组与恢复期组之间HPIgG、lgA、IgM无统计意义(P>0.05)。HP IgG、IgA、IgM对脑出血的贡献率分别为52%、28%、15%。与氧化修饰低密度脂蛋白(oxlol)呈正相关,(r=0.23,P<0.05),与高密度脂蛋白(HDL)呈负相关(r=-0.32,P<0.01)。结论 HP特异抗体IgG、IgA、IgM阳性是脑出血发生的危险因素,其中HPIgG阳性与脑出血的关系更为密切。HP特异抗体的致病作用部分通过对血脂的不利因素实现。  相似文献   

6.
心磷脂抗体与缺血性脑血管病   总被引:1,自引:0,他引:1  
目的 建立测定血清心磷脂抗体(A-CL)的方法,研究A-CL与缺血性脑血管病的关系。方法 建立心磷脂抗体的ELISA检测方法,对42例健康者和85例缺血性脑血管病、其他神经系统疾病患者血清A-CL(IgG,IgM)进行测定。结果 51例缺血性脑血管病中,11例A-CL IgG阳性,5例A-CL IgM阳性,脑出血及其他神经系统疾病均为阴性。结论 心磷脂抗体与缺血性脑血管病密切相关。  相似文献   

7.
抗心磷脂抗体与脑血管病相关性研究   总被引:10,自引:0,他引:10  
目的研究抗心磷脂抗体(ACA)与脑血管病的关系,为脑卒中的预测提供临床依据。方法采用前瞻性研究方法,对91例脑梗死(CI)、42例脑出血(CH)患者及30例健康者血清中的抗心磷脂抗体(ACA)进行检测。结果CI及CH组ACA总阳性率、IgG型ACA阳性率均显著高于对照组。ACA阳性卒中容易复发,病灶常为多个。ACA在脑卒中发病一周内阳性率最高,且抗体分型以IgG型为主。结论ACA是CI及CH的危险因素,对脑卒中的预测有一定意义。  相似文献   

8.
目的探讨病毒性脑炎的脑脊液和血清病毒IgM抗体检测对病毒性脑炎的诊断特异性和应用价值。方法78例于2007年4月~2008年6月就诊于我院,诊断为病毒性脑炎(46例)、脑膜炎(32例)的患者,于入院10d内对血和脑脊液病毒IgM抗体检测。结果78例患者血清中共检测出病毒抗体阳性48例,阳性率61.5%。以COXB和EBV为主要病原。78例患者中有52例进行了脑脊液抗体检测,阳性9例,阳性率17.3%。以HSV和EBV为主要病原。78例患者中有39例行镜下细胞学分类,淋巴细胞为主32例、单核细胞为主1例、中性粒细胞为主6例。结论用ELISA法检测病毒特异性IgM抗体是早期确定病毒性脑炎病原的较理想方法,CSF细胞学检查快速、简便,是诊断CNS病毒感染的重要指标之一。  相似文献   

9.
抗心磷脂抗体水平与缺血性脑血管病的关系   总被引:3,自引:0,他引:3  
研究抗心磷脂抗体(aCL)水平与缺血性脑血管病(ICVD)的关系.ELISA定量检测266例ICVD患者血清aCL,并与147例健康者对照.结果:ICVD组aCL阳性率为23.3%,对照组为4.76%,前者明显高于对照组(P<0.01),且IgG型aCL比IgM型aCL阳性率明显升高(P<0.01),提示aCL(特别是IgG型)与 ICVD密切相关.aCL≥10GPL或MPL的ICVD患者发病年龄轻且易复发.提示:对于年轻、有反复发作史和原因不清的ICVD患者检测aCL是必要的,aCL升高可作为ICVD危险性增加的指标.  相似文献   

10.
目的评价P2蛋白抗体在辅助吉兰-巴雷综合征(GBS)临床诊断中的价值.方法用ABC-ELISA方法检测64例血清和CSF配对的GBS病人样品中IgG和IgM型P2抗体水平.结果 GBS患者CSF中IgM型P2抗体阳性率明显高于其它神经系统疾病组和正常对照组(P<0.01),且重症型GBS病人高于轻症型病人(P=0.0019),血清与CSF间P2抗体水平无相关性.结论 GBS病人CSF中存在P2特异性免疫球蛋白,CSF中IgM型P2抗体检测有助于辅助GBS的临床诊断和病情评价.  相似文献   

11.
Borrelia burgdorferi antibodies in multiple sclerosis patients   总被引:1,自引:0,他引:1  
P K Coyle 《Neurology》1989,39(6):760-761
Lyme disease is said to produce a late syndrome resembling multiple sclerosis. We analyzed serum antibodies to Borrelia burgdorferi in 100 patients referred for possible MS. All lived in an area endemic for Lyme disease. Only 1 of 89 definite MS patients and 2 of 11 non-MS patients were antibody positive. Infection with Borrelia burgdorferi is rare in MS, and Lyme disease is unlikely to play a significant role in the differential diagnosis of MS.  相似文献   

12.
目的探讨脑梗死与HCMV、HSV1、HSV2、CP和HP活动性感染的相关性。方法用ELISA方法检测了209例(PS56例、CI88例和AS65例)患者血清HCMV、HSV1、HSV2、CPIgM抗体和122例(PS28例、CI55例和AS39例)患者HPIgM抗体。结果HCMV、HSV1、HSV2、CP和HPIgM抗体阳性率在PS、CI和AS组分别为58.93%、38.64%、29.23%;17.86%)、14.77%、10.77%;10.71%、9.09%、9.23%;16.07%(9/56)、9.09%、9.23%;60.71%、60%、48.72%。HCMV-IgM抗体阳性率PS与CI组比较有显著性差异(P<0.05);脑梗死(PS+CI)组与AS组比较有显著性差异(P<0.05);3组多重感染率(分别为44.64%、28.41%、23.08%)比较,PS与CI、AS组有显著性差异。其他病原微生物IgM抗体阳性率各组间无显著性差异。结论脑梗死的发生及病情进展与HCMV激活感染相关,与HCMV、HSV1、HSV2、CP和HP的多重感染有关。  相似文献   

13.
INTRODUCTION: The clinical spectrum of peripheral neuropathies in Lyme disease is very wide. We report a case which was revealed by an ataxic sensory neuropathy. OBSERVATION: A 77-year-old patient presented with a subacute ataxic sensory neuropathy which occurred 2 weeks after a skin lesion involving the right lower limb. He fully recovered after specific antibiotic treatment. EMG was suggestive of a predominantly axonal neuropathy. Diagnosis of Lyme disease was assessed by progressive elevation of serum antibodies, demonstration of a lymphocytic meningitis and intrathecal synthesis of antibodies. CONCLUSION: Lyme disease may be added to the list of diseases which may induce subacute sensory neuropathies.  相似文献   

14.
Paired serum and cerebrospinal fluid (CSF) samples from 800 patients of a neurological clinic were tested for antibodies to Borrelia burgdorferi. A flagellum enzyme-linked immunosorbent assay was used for antibody screening. All serum/CSF pairs with any elevated antibody response were also tested by a Western blot, a method for confirmation. 65 patients (8.1%) had serum IgG antibodies on ELISA screening and 22 of these (2.8%) were confirmed by Western blot. 20 patients (2.5%) had elevated antibody titers in CSF by ELISA and 12 of these (1.5%) reacted to the Western blot. Clinical features of Bannwarth's syndrome (BS) were present in 12 patients (1.5%) and four patients (0.5%) showed other manifestations of Lyme borreliosis. All patients with Bannwarth's syndrome were positive in serum by both methods and 10 had elevated antibody activity in the CSF proven by the two methods. The combination of a sensitive ELISA for screening and a sensitive and specific Western blot for confirmation reduces the number of positive results but is sensitive in detecting active disease.  相似文献   

15.
Acute peripheral facial palsy in adults   总被引:3,自引:0,他引:3  
Objective To collect epidemiological data of peripheral facial palsy, and especially to chart the incidence and clinical characteristics of Lyme associated facial palsy.Material and methods We included consecutive adult patients presenting with peripheral facial palsy in Vest–Agder County from January 1997 to December 1998. The facial palsy was graded according to the House and Brackman facial function scoring system,and cerebrospinal fluid and serum samples were examined for Borrelia burgdorferi antibodies and virus antibodies. Final outcome was evaluated by follow up visits or telephone interview.Results Sixty nine patients were included and followed until complete recovery, or for 5 years. Ten per cent were caused by Lyme disease, 17% by virus infection, 4% by other causes and 68% were classified as Bell’s palsy. All patients with Lyme facial palsy had additional neurological symptoms, and 87% reported constitutional complaints. The overall final outcome was good with complete recovery in 77%, slight sequelae in 20% and moderate sequelae in 3%. No patients experienced severe sequelae. Two of 28 patients examined with neurography had absent compound muscle action potentials in orbicularis oculi. Both made good recovery with only slight sequelae.Conclusions Peripheral facial palsy is a common disorder with a favourable prognosis. Lyme disease seems to be an infrequent cause of facial palsy in patients without constitutional symptoms or additional neurological findings.  相似文献   

16.
Pseudotumor cerebri is an unusual presentation of Lyme disease. The case of an 8-year-old girl with pseudotumor cerebri secondary to acute neuroborreliosis is reported. She presented with acute onset of headache, papilledema, sixth nerve palsy, increased intracranial pressure, and cerebrospinal fluid pleocytosis. Serum and cerebrospinal fluid Lyme antibodies were positive. Twelve reported cases that mostly presented with systemic findings and signs of Lyme disease before development of pseudotumor cerebri were reviewed. We conclude that acute neuroborreliosis can present with pseudotumor cerebri as an initial manifestation. It is important to include Lyme disease in the differential diagnosis of pseudotumor cerebri in an area endemic for Lyme disease.  相似文献   

17.
A R Pachner  N S Ricalton 《Neurology》1992,42(11):2185-2192
The antibody response to Borrelia burgdorferi is widely used in the diagnosis of Lyme neuroborreliosis and other manifestations of Lyme disease. However, a problem with immunoassays has been a significant number of false positives. The Western blotting technique is a useful adjunct in the serodiagnosis of other infections, but its use in Lyme borreliosis has been limited because of a lack of definition of what constitutes a positive assay. Using a gel densitometric analysis, we devised quantitative criteria for positivity and tested our criteria by matching blot results with clinical characteristics in a retrospectively studied group of 20 patients with Lyme disease, 23 healthy controls, and 18 patients with other neurologic and rheumatologic diseases. We then evaluated these criteria prospectively in serum from 35 ELISA-positive patients, and found that the serum from the majority of patients with positive serologies by ELISA were negative by Western blot. The Western blot-negative seropositive patients usually had other inflammatory or infectious diseases. We conclude that quantitative Western blotting is a helpful test in the serodiagnosis of Lyme neuroborreliosis and other manifestations of Lyme disease.  相似文献   

18.
Purposes: To chart clinical, laboratory, and psychometric profiles in patients who attribute their complaints to chronic Lyme disease. Methods: We assessed the patients by clinical examination, laboratory tests, and questionnaires measuring fatigue, depression, anxiety, health‐related quality of life, hypochondriasis, and illness perceptions. Results: We found no evidence of ongoing Borrelia burgdorferi (Bb) infection in any of the 29 included patients using current diagnostic guidelines and an extended array of tests. Eight (28%) had other well‐defined illnesses. Twenty‐one (72%) had symptoms of unknown cause, of those six met the suggested criteria for post‐Lyme disease syndrome. Fourteen (48%) had presence of anti‐Bb antibodies. The patients had more fatigue and poorer health‐related quality of life as compared to normative data, but were not more depressed, anxious, or hypochondriacal. Their beliefs about the illness were characterized by negative expectations. Conclusion: Our patients, who all attributed their symptoms to chronic Lyme disease, were heterogeneous. None had evidences of persistent Bb infection, but whether current diagnostic criteria are functional in patients with longstanding complaints is controversial. Other well‐defined illnesses or sequelae from earlier Lyme disease were probable as main explanatory factor in some cases. The patients were not more depressed, anxious, or hypochondriacal than the normal population, but they had poorer health‐related quality of life, more fatigue, and negative expectations about their illness.  相似文献   

19.
目的 探讨重症肌无力(MG)患者血清Titin抗体及乙酰胆碱受体(AchR)抗体的检测意义.方法 采用酶联免疫吸附试验(ELISA)对81例MG患者和80例对照组成员进行Titin和AchR抗体的检测.结果 Titin抗体对MG具有特异性,它在合并胸腺瘤的MG(MGT)、晚发型MG患者中有较高的阳性率(分别为80%、69.4%)和抗体水平,明显高于早发型MG患者的阳性率(25%)和抗体水平,差异均有统计学意义(P<0.05).而早发型MG患者中AchR抗体阳性率比晚发型MG患者明显增高.并且早发型MG患者的AchR抗体水平也明显高于晚发型MG和MGT患者,差异均有统计学意义(P<0.05).结论 两种抗体检测为MG诊断和病因学研究提供了重要证据,联合检测可以提高MG诊断的灵敏度.  相似文献   

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