唾液抗幽门螺杆菌IgG检测诊断幽门螺杆菌感染的评价

目的 评价唾液抗幽门螺杆菌（ＨＰ）抗体诊断ＨＰ感染的价值。方法 ９３例病人同时进行唾液抗ＨｐＩｇＡ测定、快速尿素酶试验（ＲＵＴ）、组织涂片ＨＥ染色及病理ＷＳ银染色法诊断ＨＰ感染结果 唾液抗ＨｐＩｇＧ检测阳性率近似于ＲＵＴ法，高于组织涂片ＨＥ染色法和病理ＷＳ银染色法，其诊断ＨＰ感染的敏感性与９６．９７％，特异性８８．２３％，准确性９５．１８％，阳性预测值９７％，阴性预测值８８．２４％，结论唾液抗Ｈｐ     

冠心病与幽门螺杆菌感染间关系初探

对无上消化道疾病症状及病史的９２例冠心病（ＣＨＤ）〔研究组〕４８例高心病及４１例风心病病人〔对照组〕，用间接酶标法测血清中抗幽门螺杆菌（ＨＰ）特异性ＩｇＧ抗体，结果表明：ＣＨＤ组中抗ＨＰ（＋）者８０．４％，明显高于高心及风心组，ＣＨＤ全组的抗ＨＰ的光密度（ＯＤ）值明显高于高心及风心全组；ＣＨＤ组中抗ＨＰ（＋）组的ＯＤ值与胆固醇（ＴＣ）、甘油三酯（ＴＧ）间明显正相关，而高心及风心组中以上参数间无相关；ＣＨＤ全组及其中抗ＨＰ（＋）组的纤维蛋白原高于高心及风心组及ＣＨＤ中抗ＨＰ（－）组提示ＣＨＤ与ＨＰ感染有关。     

甲型肝炎患者抗－HAV－IgM特异性循环免疫复合物的检测及其动态变化

甲型肝炎患者抗－ＨＡＶ－ＩｇＭ特异性循环免疫复合物的检测及其动态变化郝春秋，阎荣，周永兴，陈龙邦，陈远鑫本文作者建立了检测抗－ＨＡＶ－ＩｇＭ特异性循环免疫复合物（ＳＣＩＣ）的聚乙二醇酶联免疫吸附法（ＰＥＧ－ＥＬＩＳＡ），对８３例急性黄疸型甲型病毒性肝...     

直接酶标法检测肝组织中丙型肝炎病毒抗原（HCAg－NS_3）的研究

以单克隆抗－ＨＣＶ－ＮＳ３直接酶标法对石蜡包埋肝组织中丙型肝炎病毒抗原（ＨＣＡｇ－ＮＳ３）进行测定，该抗体系应用基因重组表达丙肝抗原（ＨＣＶ－ＮＳ３区－Ｃ３３－Ｃ）免疫小鼠并通过细胞融合术后获得。４９例病毒性肝炎患者肝组织测定结果，抗－ＨＣＶ阳性组的ＨＣＡｓ－ＮＳ３检出率为５１．９％（１４／２７），抗－ＨＣＶ阴性组为１３．６％（３／２２），两组有显著性差异（Ｐ＜０．０１），以慢性重症肝炎和肝硬化患者检出率最高，ＨＣＡｇ－ＮＳ３阳性物在肝细胞的胞核或胞浆中均可见，呈棕黄色细小颗粒状，以核型居多。直接酶标法测定ＨＣＡｇ与原位杂交法测定ＨＣＶＲＮＡ的比较，其符合率为８１．６％（４０／４９）。本项技术具有简便、快捷、特异性、敏感性佳、图象清晰等优点，易于推广应用，为ＨＣＶ感染的临床和发病机理研究提供重要检测手段。     

肝病患者HCV感染的易感因素及作用探讨

采用间接酶联免疫法检测了１０１例临床诊断为乙型和非甲非乙型肝炎患者中抗－ＨＣＶ（Ｃ５５ＡＡ和ＮＳ３６６ＡＡ的多肽抗体）结果提示：在ＨＢＶ相关性肝病及临床诊断的ＮＡＮＢ肝炎中，抗ＨＣＶ检出率为２１．２８％和５９．２６％。进一步分析发现ＨＢＶ感染及活动性复制，受血治疗和机体的基本状态差等是ＨＣＶ感染及肝脏损害的有利因素。     

肝病患者中HCV感染的易感因素及作用探讨

采用间接酶联免疫法检测了１０１例临床诊断为乙型和非甲非乙型肝炎患者中抗－ＨＣＶ（Ｃ５５ＡＡ和ＮＳ_３６６ＡＡ的多肽抗体）结果提示：在ＨＢＶ相关性肝病及临床诊断的ＮＡＮＢ肝炎中，抗ＨＣＶ检出率为２１．２８％和５９．２６％。进一步分析发现ＨＢＶ感染及活动性复制，受血治疗和机体的基本状态差等是ＨＣＶ感染及肝脏损害的有利因素。     

聚合酶链反应诊断结核性腹膜炎的评价

目的评价聚合酶链反应（ＰＣＲ）方法对结核性腹膜炎的诊断价值。方法用ＰＣＲ技术检测３０例结核腹水中结核分支杆菌ＤＮＡ，并与腹水涂片抗酸染色及酶联免疫吸附试验（ＥＬＩＳＡ）检测腹水中抗ＰＰＤ抗体进行比较。结果ＰＣＲ的阳性率为６０％，特异性９４．４％；ＥＬＩＳＡ法阳性率６３．３％，特异性７２．２％；涂片镜检均为阴性。结论ＰＣＲ在诊断结核性腹膜炎具有较高的敏感性和特异性，优于ＥＬＩＳＡ法及涂片镜检，如与ＥＬＩＳＡ技术结合可进一步提高检测的敏感性和特异性。     

结核性腹膜炎的实验室诊断

目的评价聚合酶链反应（ＰＣＲ）结合Ｓｏｕｔｈｅｒｎ杂交技术及酶联免疫吸附试验（ＥＬＩＳＡ）对结核性腹膜炎的诊断价值。方法用ＰＣＲ结合地高辛标记核酸探针Ｓｏｕｔｈｅｒｎ杂交技术检测４２例结核性腹水中结核分支杆菌ＤＮＡ，并与常规细菌学检测及ＥＬＩＳＡ对比。引物来自结核分支杆菌特异重复插入序列ＩＳ６１１０。特异性通过杂交及限制性内切酶ＳａｌⅠ酶切证实。同时比较了Ｓｏｕｔｈｅｒｎ杂交检测与凝胶电泳检测的敏感性。结果ＰＣＲ的敏感性为６９％，ＥＬＩＳＡ为７１％，培养为９％，涂片镜检均为阴性。并发现杂交较凝胶电泳检测更敏感。结论ＰＣＲ和ＥＬＩＳＡ法对结核性腹膜炎有较高的诊断价值，但前者更具有特异性。将Ｓｏｕｔｈｅｒｎ杂交技术与ＰＣＲ技术结合，可进一步提高检测的敏感性和特异性。     

三种血清学试验检测旋毛虫病抗体的研究

用免疫酶染色试验（ＩＥＳＴ）间接血凝试验（ＩＨＡ）和玻片法环蚴沉淀试验（Ｓｌｉｄｅ）３种血清学方法检测感染旋毛虫豚鼠血清，阳性率分别为９７．１％，１００％和９６．７％，用此３种血清学方法检测正常豚鼠，血吸虫病兔，肺吸虫病大白鼠，蛔虫病人和鞭虫病人血清，除１例肺吸虫病大白鼠血清ＩＨＡ出现阳性反应外，其它血清３种方法均为阴性反应，结果表明３种方法对旋毛虫病特异性抗体的检测均有较好的敏感性和特异性。     

浸棒-夹心-胶体染料免疫试验检测血吸虫病患者循环抗原方法的建立及应用

目的：建立检测感染宿主血清中循环抗原的简易免疫学试验方法。方法：从国产的工业染料中首次筛选出 １ 种能用于免疫显色反应的淡紫色染料莲（ Ｈ Ｆ Ｒ Ｌ）,用 Ｉｇ Ｍ 类别抗日本血吸虫组合单抗 Ｄ Ｈ Ｃ 标记染料,并探索最适标记条件。建立浸棒 夹心 胶体染料免疫试验（ Ｄ Ｓ Ｄ Ｉ Ａ）,检测宿主血清中日本血吸虫循环抗原。结果： Ｄ Ｓ Ｄ Ｉ Ａ检测日本血吸虫 Ｓ Ｅ Ａ 的最低检出极限为 ５ ｎｇ／ｍ ｌ,分别检测急性血吸虫病患者 １４ 例及慢性血吸虫患者 １１３ 例的血清,其阳性率分别为 １００％ 和 ５２．２％ ,检测正常学生血清 １１３ 例,特异性为 ９２．９％ 。该法的敏感性及特异性与ｄｏｔ Ｅ Ｌ Ｉ Ｓ Ａ 相似,且两法联合检测可提高检出率,而特异性不变,提示两法有一定的诊断互补叠加效应。标记染料室温下保存 １ ｗ ｋ 活性不变。结论： Ｄ Ｓ Ｄ Ｉ Ａ 操作简便、试剂价廉,有广泛的应用潜力。     

Clinical significance of PCR in Helicobacter pylori DNA detection in human gastric disorders

ＣｌｉｎｉｃａｌｓｉｇｎｉｆｉｃａｎｃｅｏｆＰＣＲｉｎＨｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉＤＮＡｄｅｔｅｃｔｉｏｎｉｎｈｕｍａｎｇａｓｔｒｉｃｄｉｓｏｒｄｅｒｓＸＵＧｕｏＭｉｎｇ，ＪＩＸｕＨｕａｉ，ＬＩＺｈａｏＳｈｅｎ，ＭＡＮＸｉａｏＨｕａ...     

Presence and characterization of Mycobacterium avium subspecies paratuberculosis from clinical and suspected cases of Crohn's disease and in the healthy human population in India.

OBJECTIVES: To investigate and characterize Mycobacterium avium subspecies paratuberculosis (MAP) in patients with Crohn's disease, attendants of animals with suspected infection, and healthy humans, using multiple diagnostic tests. METHODS: A total of 119 samples (35 stool, 76 serum, three blood clots, and five biopsies) were collected from five patients with Crohn's disease, eight attendants of animals with Johne's disease, and 93 apparently normal control subjects (Agra region) from North India. Samples were screened for the presence of MAP by smear examination, culture of stool, blood clot and biopsies, and ELISA. Colonies obtained by culture were further characterized using polymerase chain reaction (PCR) with IS900 MAP-specific primers. RESULTS: Using all diagnostic modalities, MAP and/or MAP antibodies were identified in 100% (5/5) of subjects with Crohn's disease; 75.0% (6/8) of attendants of MAP infected animals were positive and 38.0% (27/71) of apparently normal controls were also positive. Most sensitive test was ELISA (100%, 5/5), followed by culture (80.0%, 4/5), and acid-fast staining. Ziehl-Neelsen staining was positive in 37.5% (3/8) of subjects with active animal husbandry practices. In 71 serum samples from control subjects, seroprevalence of MAP was 38.0% using indigenous protoplasmic antigens (PPA) and 36.6% using commercial PPA. Of the serum samples from the Crohn's disease patients, 100% (5/5) were positive by ELISA using indigenous PPA and 40.0% (2/5) were positive by ELISA using commercial PPA. IS900 PCR was used to characterize tiny colonies of MAP that grew extremely slowly on Herrold's egg yolk medium, and of 15 (42.8%) cultures, 14 (93.3%) were typed as MAP. CONCLUSIONS: Paper documented the presence of MAP in all patients with Crohn's disease, in some animal attendants who had the history of working with goat herds infected with Johne's disease and in few normal healthy individuals. Presence of Ziehl Neelsen positive MAP. In the stool of attendants working with MAP-infected animals was unique to humans. ELISA based on antigens derived from indigenous MAP 'bison type' genotype of goat origin was most sensitive modality for screening Crohn's disease patients.     

猪血清中抗人幽门螺旋菌IgG的检出及其意义

以ELISA法测定了69份猪血清中抗HP抗体IgG,阳性34份,阳性率为49.28％。以吸收试验证明,该抗体与空肠弯曲菌、大肠埃希氏菌无交叉反应,仅与幽门螺旋菌(Helicobacter Pylori后简称HP)有特异性反应。对抗体阳性猪胃粘膜切片HE染色检查,91.2％有明显的炎症反应。从而提示猪有可能自然感染HP。     

NP30/抗体检测试剂盒在云南大山区型血吸虫病流行区的现场应用

目的用NP30/抗体检测试剂盒在大山区型血吸虫病流行区筛查病人,评价其应用价值。方法在云南省大山区型血吸虫病流行区,选择3个自然村作为现场,随机抽取10～70岁的村民作为调查对象,进行血吸虫病病史个案调查;收集粪便,作毛蚴孵化检查;静脉采血,分离血清,分别采用NP30/抗体检测试剂盒和酶联免疫吸附试验试剂盒（SEA/ELISA法）检测特异性IgE和总IgE抗体。结果3个村共筛查村民506人,粪便毛蚴孵化阳性164例,阳性率为32.41%;NP30和SEA/ELISA的阳性率分别为58.30%和75.10%。在164例粪检阳性血清样本中,NP30和SEA/ELISA的阳性符合率分别为87.80%和84.76%。在342例粪孵阴性血清样本中,NP30和SEA/ELISA的阳性率分别为44.15%和70.47%。结论NP30/抗体检测试剂盒具有较高的敏感性和特异性,可用于大山区型血吸虫病流行区病人筛查。     

Seroepidemiology of schistosomiasis japonica by ELISA in the Philippines. II. Unreliability of stool examination in the measurement of incidence

It was shown in a previous study that a single quantitative stool examination (by technics currently used in the Philippines) is so sensitive that it underestimated by 50% the prevalence of schistosomiasis japonica in children detected by a single serologic assay (ELISA). This paper proves that measurement of incidence of the infection among these same children by stool examination is unreliable as well. Three important sources of error in the measurement of incidence by stool examination are: (a) the inclusion of already infected children in the group of presumably uninfected children in which conversion (change from negative to positive) is being measured; (b) the insensitivity of stool examination in identifying those who do acquire infection among the initially uninfected; and (c) spontaneous, possibly temporary, stool reversion. An overestimation of incidence results from error (a) because already infected children have 5-7 times the tendency to convert than do uninfected children; error (b) tends to produce an underestimation of incidence since stool examination will detect only about one-half of the children who do become infected; while error (c) also tends to cause an underestimation of incidence and is dependent on the frequency of stool examinations--34% of the conversions observed by multiple examinations may not be detected in a single year-end examination. The equivalent sources of error are insignificant when ELISA is employed to measure incidence. In the 3 years of observation, the annual incidence of schistosomiasis japonica measured by ELISA showed no significant change (13.5%, 16.7%, and 15.6%); on the other hand, the annual incidence measured by stool examination showed a significant reduction from 37.5% down to 16.0% and 15.1%. Significant sources of error invalidate measurements by stool examination; it is therefore concluded that incidence measurements have failed to produce acceptable evidence of reduction in transmission in the area of study in the 3 years of control operations. We believe that insistence on relying almost exclusively on the parasitologic technic can result in an erroneous evaluation of the control program currently being implemented.     

胆结石患者血清和胆汁幽门螺杆菌相关蛋白免疫印迹检测

目的：研究幽门螺杆菌（HP）感染与胆石形成的关系。方法：采用聚合酶链免疫吸附法（ELISA）对胆结石患者的血清及胆汁免疫球蛋白IgG,IgA,IgM标本进行检测，对血清学及胆汁IgG均阳性患者的胆汁，采用免疫印迹法（Western blot)进行HP感染相关蛋白检测。结果：胆结石组50例患者中血清学及胆汁IgG均阳性者29例（58.0%)，另取非胆结石组13例作为对照，胆结石组与非胆结石组血清及胆汁HP免疫印迹检测，均可检出4种主要HP感染相关蛋白，但胆结石组血清及胆汁中UreA检出率较非胆结石组高。结论：胆汁中存在多种HP感染相关蛋白，并可能参与胆结石的形成。     

血吸虫病疫情控制地区查病方案研究

目的 探讨适合血吸虫病疫情控制地区的查病方案。方法 选择江滩型血吸虫病流行区的扬州市邗江区沿江村6～65岁人群作为查病对象，按照单盲试验的原则，同时用DDIA4-Kato-Katz法、DDIA＋集卵孵化法、ELISA＋Kato-Katz法和ELISA＋集卵孵化法4种查病方案进行查病，分析病人漏检原因，比较各种查病方案的漏检率和查病费用。结果 对1251人进行了查病，受检率为92．19％，共查出血清学阳性298例，粪检阳性29例。其中DDIA＋KatoKatz法、DDIA＋集卵孵化法、ELISA＋Kato-Katz法和ELISA＋集卵孵化法4种查病方案分别查出粪检阳性病人19、26、19例和24例，分别漏检10、3、10例和5例，漏检率分别为34．48％、10．34％、34．48％和17．24％；4种方案人均查病费用分别为6．83、7．06、7．33元和7．62元。DDIA、ELISA筛查时分别漏检病人1例和2例；Kato-Katz、集卵孵化法分别漏检病人9例和3例，漏检率为31．03％和10．34％。结论 DDIA＋集卵孵化法或ELISA＋集卵孵化法均可作为血吸虫病疫情控制地区的查病方案，但DDIA＋集卵孵化法更有效、经济。     

胶体染料试纸条法免疫诊断试剂盒在大山区型血吸虫病流行区的现场应用

目的现场评价胶体染料试纸条法(DDIA)免疫诊断试剂盒在大山区型血吸虫病流行区筛查病人中的应用价值。方法在云南省大山区型血吸虫病流行区,选择3个自然村作为调查现场, 随机抽取10-70岁的村民作为调查对象,进行血吸虫病病史个案调查;收集粪便标本,采用改良 Kato-Katz法(1送3检)作病原学检查;静脉采血,分离血清,分别采用DDIA诊断试剂盒、酶联免疫吸附试验(ELISA)诊断试剂盒和环卵沉淀试验(COPT)诊断试剂盒进行血吸虫病免疫学诊断。结果 3个村共筛查村民659人,Kato-Katz法粪检阳性187例,阳性率为28．4％;DDIA、ELISA和 COPT的阳性率分别为70．9％,84．2％和54．9％;在187例粪检阳性者中,DDIA、ELISA和COPT 的阳性符合率分别为98．4％、96．8％和81．8％。结论 DDIA免疫诊断试剂盒在大山区型血吸虫病流行区现场大规模筛查病人中具有较高的敏感性和特异性。     

Tetracycline, metronidazole and amoxicillin-metronidazole combinations in proton pump inhibitor-based triple therapies are equally effective as alternative therapies against Helicobacter pylori infection

Background: A proton pump inhibitor (PPI)‐based triple therapy with clarithromycin (CAM) and amoxicillin (AMPC) is now a standard regimen for Helicobacter pylori (HP) eradication in Japan. However, the CAM‐resistant rate has increased recently and alternative therapies are sorely needed. Therefore the aim of the present study was to evaluate the effectiveness and safety of the PPI–tetracycline (TC)–metronidazole (MNZ) regimen (the PTM regimen) as an alternative therapy in comparison with the PPI–AMPC–MNZ (PAM) regimen. Methods: Sixty‐four HP‐positive patients visiting the HP‐eradication clinic in Tokai University Hospital from July 1998 to March 2003 were treated with either PTM or PAM as alternative therapies. The HP eradication was assessed by urea breath test (UBT), HP stool antigen test, or HP culture method more than 2 months after completion of the treatments. The drug resistances against CAM, AMPC, TC, and MNZ were assessed by the agar dilution method. Results: Fifty‐six patients (26 PTM and 30 PAM) completed medication and evaluation of the eradication. The eradication rates of PTM were 82.8% (24/29) and 92.3% (24/26), while those of PAM were 74.3% (26/35) and 89.7% (26/29) by intention‐to‐treat and per‐protocol analysis, respectively. The differences between the regimens were not statistically significant. There were no severe adverse effects observed in either of the regimens. The drug‐resistance analyses showed 15 CAM‐ and one MNZ‐resistant cases but no TC or AMPC resistance in the available 25 samples. Conclusion: The PTM and PAM regimens were equally effective and safe as alternative HP eradication therapies. And PTM would be particularly useful in penicillin allergy cases.     

Hunger pain: a poor indicator of peptic ulcer in a developing country

Endoscopy of the esophagus, stomach, and duodenum and stool examinations for ova and parasites were performed in 63 adult Peruvian patients with "hunger pain" (HP) and other dyspeptic symptoms. No lesion capable of provoking HP was found at endoscopy in 50 (78%) of the 63 patients. Only 7 (12%) of the patients had evidence of active or healed peptic ulcers. Another 6 patients (10%) had either gastric erosions or duodenitis. One (2%) of the patients was infected with hookworm, a parasite that produces epigastric pain mimicking HP. The 12% rate of peptic ulcer in Peruvian patients with HP contrasts strongly with accumulated experience in most developed countries, whose rates of peptic ulcer associated with HP range from 60 to 75%. As the frequency of peptic ulcer is so variable in patients with HP, we suggest that the simple term "hunger pain" be used instead of "peptic ulcer pain" or "ulcer dyspepsia" to refer to the complaint of such patients.