应用ELISA检测阿米巴脓抗原和循环抗原诊断阿米巴肝脓 …

应用ＥＬＩＳＡ法检测阿米巴肝脓肿患者脓液和血清标本中的阿米巴抗原,结果４２例患者中有４１例检出脓抗原检出率为９７．６％,其中包括８例镜检阿米巴滋养体阳性和３３例镜检阴性者;有３９例检出循环抗原,检出率为９２．９％,脓抗原阳性反应强度高于循环抗原者（Ｐ〈０．０５）,各种对照标本的阿米巴抗原检出的率为０,提示可用ＥＬＩＳＡ抗原检测法替代镜检和培养法进行阿米巴肝脓肿的病原学诊断。     

用聚合酶链反应检测血清标本诊断阿米巴肝脓肿的价值

用聚合酶链反应（ Ｐ Ｃ Ｒ）检测阿米巴肝脓肿患者血清标本中的溶组织内阿米巴 ３０ ０００ 蛋白基因,结果４２ 例患者中有３５ 例呈阳性反应,阳性率为８３．３％ ,低于脓标本 Ｐ Ｃ Ｒ阳性率（１００％ ）（ Ｐ＜ ０．０１）。３ 例细菌性肝脓肿、１ 例肝癌及１０ 例其它部位脓肿患者的血清和脓对照标本 Ｐ Ｃ Ｒ均呈阴性反应。对 Ｐ Ｃ Ｒ检测血标本诊断阿米巴肝脓肿的价值进行了讨论。     

用聚合酶链反应检测血清标本诊断阿米巴肝脓肿的价值

用聚合酶链反应（ＰＣＲ）检测阿米巴肝脓肿患者血清标本中的溶组织内阿米巴３００００蛋白基因,结果４２例患者中有３５例呈阳性反应,阳性率８３．３％,低于脓标本ＰＣＲ阳性率（１００％）（Ｐ〈０．０１）。３例细菌性肝脓肿、１例肝癌及１０例其它部位脓肿患者的血清和脓对照标本ＰＣＲ均呈阴性反应。对ＰＣＲ检测血标本诊断阿米巴肝脓肿的价值进行了讨论。     

溶组织内阿米巴5例的粪便鉴定

目的探讨溶组织内阿米巴的粪便鉴定,并就溶组织内阿米巴包囊及滋养体的镜检要点及常见漏检原因进行讨论。方法用显微镜法对5例外院漏诊的肠阿米巴病患者粪便标本进行检验,分别用生理盐水涂片法、碘染色和苏木素染色法,在显微镜下进行观察鉴定。结果溶组织内阿米巴包囊及滋养体在生理盐水涂片、碘染色涂片和苏木素染色涂片中有典型的形态学特点。结论对于可疑肠阿米巴病患者,应多次及时送标本进行检验,采用几种不同方法进行鉴定,并注意将溶组织内阿米巴与吞噬细胞及迪斯帕内阿米巴相鉴别。     

多聚酶链反应在鉴别溶组织内阿米巴致病与非致病株及阿米 …

用福尔马要固定粪便标本，从中抽提ＤＮＡ。采用两对可区别溶组织内阿米巴致病与非致病的引物进行了ＰＣＲ扩增。３２例经镜检证实的溶组纳内阿米巴带囊者均呈ＰＣＲ阳性反应，其中６例（１８．８％）仅对致病性引物、２５例（７８．１％）仅对非致病引物显示阳性反应，１例（３．１％）则对致病及非致病引物均呈阳性反应。致病性ＰＣＲ阳性者与受试者的临床表现（腹泻或痢疾粪便）密切相关（ＯＲ＝３１．５）。所有对照者（粪便中无     

棘阿米巴角膜炎的实验诊断

[目的 ]寻找棘阿米巴角膜炎快速诊断和棘阿米巴快速鉴定的方法。 [方法 ]10 %氢氧化钾 (KOH)湿封片镜检、棘阿米巴培养、倒置显微镜观察、病理切片H .E .染色和SPA染色检查。 [结果 ]角膜刮片及手术切除的角膜材料 ,经 10 %氢氧化钾湿封片镜检 ,前者检出 7例棘阿米巴角膜炎病例 ,后者确诊 5例 ;手术切除的角膜材料经培养 ,分离出 6株棘阿米巴 ;应用倒置显微镜直接观察 ,检出棘阿米巴的包囊、滋养体和棘刺。 [结论 ]应用 10 %KOH湿封片镜检可对棘阿米巴角膜炎作出快速诊断 ;通过倒置显微镜直接观察也可对棘阿米巴角膜炎在 2 0h内作出诊断 ;倒置显微镜可直接观察和鉴定棘阿米巴 ,方法简便、无污染、快速及实用。     

兰州市慢性病患者隐孢子虫和溶组织阿米巴感染流行病学调查结果分析

目的了解兰州市慢性病（主要为高血压、糖尿病和恶性肿瘤）人群隐孢子虫和溶组织阿米巴的感染状况。方法在兰州市收集高血压、糖尿病、恶性肿瘤及非慢性病患者等的粪便,分别采用改良抗酸染色法和碘染色法,检测粪便中的隐孢子虫卵囊和溶组织阿米巴包囊。结果在600例粪便中,隐孢子虫和溶组织阿米巴感染率分别为4．17％和4．50％,感染率差异无统计学意义（χ2=0．080,P〉0．05）;男性感染率分别为4．67％和4．33％,女性感染率分别为3．67％和3．oO％;〈10岁者隐孢子虫和溶组织阿米巴的感染率最高,分别为6．00％和7．00％;糖尿病和恶性肿瘤组隐孢子虫的感染率分别为7．00％和10．。0％,与对照组比较差异有统计学意义（χ2=4．178,7．639;P〈0．05）;糖尿病和恶性肿瘤组溶组织内阿米巴的感染率分别为9．00％和8．33％,与对照组比较差异有统计学意义（χ2=6．866,4．108;P〈0．05）。结论兰州市隐孢子虫和溶组织阿米巴儿童和慢性病患者人群感染率较高,可能与该人群健康状况、免疫力和卫生习惯等密切相关。     

上海市综合性医院腹泻患者中溶组织内阿米巴感染现状调查

目的 了解综合性医院腹泻患者溶组织内阿米巴感染现状,为防治工作提供科学依据。方法 选择上海市3所综合性医院肠道门诊,采集门诊腹泻患者新鲜粪便和血清,分别采用生理盐水涂片法和碘液染色法、免疫层析法、ELISA法进行检测,以了解腹泻患者溶组织内阿米巴感染状况,并对感染者特征进行分析。结果 检测腹泻患者粪便样本 1 015份, 检出溶组织内阿米巴原虫病原学阳性36份, 总阳性率为3.55%。3所医院腹泻患者病原学阳性率间差异无统计学意义（P > 0.05）,溶组织内阿米巴阳性者性别、年龄、职业和文化程度分布差异均无统计学意义（P均 > 0.05）,脓血便中溶组织内阿米巴阳性率显著高于稀便和水样便（P均 < 0.01）。7-9月为发病高峰。88.90%的阳性者有腹痛,75.00%和22.23%的阳性者粪便查见白细胞和红细胞。试剂条法检测溶组织内阿米巴粪抗原阳性率为8.18%（83/1 015）,ELISA 法检测溶组织内阿米巴IgG抗体阳性率为7.12%（48/675）。结论 夏秋季是溶组织内阿米巴感染高发季节,应加强监测;脓血便中溶组织内阿米巴检出阳性率较高,联合应用多种检测手段能提高检出率。     

溃疡性结肠炎合并阿米巴肠病临床特点探讨

目的 探讨溃疡性结肠炎合并阿米巴肠病的临床特点.方法 回顾性分析2003～2010年共104例溃疡性结肠炎患者诊治资料,其中15例确诊合并阿米巴肠病(A组),单纯性溃疡性结肠炎患者89例(B组),统计各患者的腹泻次数、贫血程度、低白蛋白血症程度及结肠病变范围.结果 A、B组患者中腹泻＞6次/d者分别为13例、40例,血红蛋白＜90 g/L患者分别为8例、16例,血清蛋白＜30 g/L患者分别为10例、23例,结肠病变范围超过1/2的患者分别为12例、31例,两组存在统计学差异;15例溃疡性结肠炎合并阿米巴肠病患者中7例为先确诊溃疡性结肠炎,后获得阿米巴感染并致病,其余8例患者无法判断两种疾病的发病先后顺序.所统计病例中溃疡性结肠炎并发阿米巴肠病发病率为14.4％(15/104),高于阿米巴肠病在普通人群中发病率(同地区平均为0.44％,最高2.43％).结论 溃疡性结肠炎合并阿米巴肠病病情较单纯性溃疡性结肠炎患者严重;溃疡性结肠炎患者较普通人群更容易获得溶组织内阿米巴感染并致病.     

3种方法检测粪便中溶组织内阿米巴的结果比较

目的比较生理盐水直接涂片法、醛醚沉淀法及ELISA 3种方法检测粪便中溶组织内阿米巴的优缺点。方法采集受检者粪便标本278份.分别采用3种方法进行阿米巴原虫感染检测,检测结果进行统计学处理,分析3种方法的阳性检出率、准确率、敏感性、特异性及费用。结果生理盐水直接涂片法、醛醚沉淀法和ELISA法的阳性率分别为9.71%、10.79%和12.23%,差异无统计学意义(P>0.05);阳性标本经PCR确证,3种方法的阳性符合率分别为48.71%、51.11%和77.36%,差异有统计学意义(P<0.05)。生理盐水直接涂片法费用低(1元/份),耗时少(0.1 h～0.2 h)。结论粪便溶组织内阿米巴检测推荐使用ELISA法,其次是醛醚沉淀法,如果用生理盐水涂片法,至少要重复检测3次。     

Detection of Entamoeba histolytica using polymerase chain reaction in pus samples from amebic liver abscess.

BACKGROUND AND OBJECTIVE: Direct demonstration of Entamoeba histolytica by conventional microscopy and in vitro culture in pus obtained from amebic liver abscess (ALA) is often unsuccessful. We evaluated polymerase chain reaction (PCR) for detection of E. histolytica DNA in such pus. METHODS: Species-specific primers were used for the amplification of E. histolytica DNA from liver pus obtained from 30 patients with ALA. Patients with pyogenic liver abscess and sterile (autoclaved) pus spiked with Entamoeba dispar and bacteria (Escherichia coli, Klebsiella spp. and Bacteroides spp.) were used as negative controls. RESULTS: PCR was positive in 83% of pus specimens from patients with ALA, and was negative in all 25 pus specimens obtained from pyogenic abscess and autoclaved pus spiked with known bacteria. Sensitivity and specificity of PCR were 83% and 100%, respectively. The overall positivity of PCR was higher compared to serological tests. CONCLUSION: PCR may be a more reliable and better alternative diagnostic modality for ALA.     

A recurrent case of amebic liver abscess seventeen years after the first occurrence

A 49-year-old male who had been diagnosed as having amebic liver abscess when he was 32-year-old was admitted to our hospital with fever and watery diarrhea. Ultrasonography and CT examination demonstrated a solitary abscess in the right lobe of the liver. Cysts of Entamoeba histolytica were detected in the stool and an aspiration of the liver abscess looked like anchovy paste. Serum amebic antibody by the IFA method was positive and the case was diagnosed as amebic liver abscess. The patient was treated with metronidazole, and percutaneous transhepatic abscess drainage was performed. The liver abscess decreased remarkably in size and serum amebic antibody was negative after the treatment. Recurrence of amebic liver abscess is rare and we report this case with some literature.     

Antigenic stability and immunodominance of the Gal/GalNAc adherence lectin of Entamoeba histolytica

Immunoprecipitation of Entamoeba histolytica proteins was performed with the sera of patients recovered from amebic liver abscess and colitis. The patients' amebic infection had been acquired in diverse areas of the world. The amebic galactose and N-acetyl-D-galactosamine-inhibitable adherence lectin was the major amebic antigen immunoprecipitated. The adherence lectin was recognized by all of the patients' sera tested regardless of the site (liver abscess vs. colitis) or geographic region that the amebic infection had occurred.     

间接荧光抗体试验诊断阿米巴病的效果

用生长在ＬＡＳ双相培养基上４８ｈ的贴壁溶组织内阿米巴作抗原和略加修改的等（１９７１）方法进行间接荧光抗体试验。结果５４例阿米巴肝脓肿病人血清或滤纸干血滴全部阳性，且滴度都较高（１：８０－１：２５６０）。２３例阿米巴痢疾患者中，１９例阳性，阳性率为８２．６％；４２例非阿米巴病和４０例正常人血清或滤纸干血滴均阴性。     

Differences in complement-mediated killing of Entamoeba histolytica between men and women--an explanation for the increased susceptibility of men to invasive amebiasis?

Men are more than 7 times more likely to develop amebic liver abscess or amebic dysentery caused by Entamoeba histolytica than women. Because the complement system could play a key role in controlling amebiasis, we determined whether serum from men and women differ in the ability to kill amebic trophozoites. We found that serum from women was significantly more effective in killing E. histolytica trophozoites than serum from men, and this killing was complement dependent. Our results provide a possible explanation for the differential susceptibility of men and women to amebic liver abscess and amebic colitis.     

Changes in bacterial profile during amebiasis: demonstration of anaerobic bacteria in ALA pus samples

Little is known about the changes in gut resident flora during amebic colitis and amebic liver abscess (ALA) caused by Entamoeba histolytica infection. Fecal samples from ALA patients, from healthy E. histolytica negative and positive (asymptomatic) individuals, and from pre- and post-metronidazole-treated healthy volunteers and pus samples from ALA patients were tested for the presence of various bacterial genera using 16S rRNA-based primers. Statistically significant reduction in Lactobacillus due to E. histolytica infection was observed in asymptomatic individuals and ALA patients. On the other hand, reduction in Bacteroides, Bifidobacterium, and Clostridium in the same samples was due to metronidazole treatment. Two anaerobic genera, viz. Bacteroides and Peptostreptococcus, were detected in ALA pus samples, and this observation is unprecedented. In addition, PCR revealed metronidazole resistance genes in fecal and pus samples of metronidazole-treated individuals. Re-examination of the ameba-bacterium relationship in amebiasis is suggested.     

阿米巴肝脓肿的诊断与治疗--附36例报告

目的分析阿米巴肝脓肿的临床特点、诊治及转归情况.方法采用回顾性方法对36例阿米巴肝脓肿患者的临床资料进行分析.结果患者的主要临床表现为上腹痛(86.1%)、发热(86.1%)、肝肿大伴触痛(83.3%)和右肋间压痛(58.3%).实验室检查可见外周血白细胞升高(61.1%)、血沉增快(88.5%)等.92.6%的患者血阿米巴抗体阳性.超声检查示75%为单个脓肿、75%为右叶肝脓肿.所有患者均者用甲硝唑治疗,其中27例患者还同时进行肝脓肿穿刺引流.经治疗后,痊愈10例,显效25例,总有效率97.2%.有1例患者死于肝功能衰竭.结论单用药物治疗对于小肝脓肿疗效好,如肝脓肿较大可同时行脓肿穿刺引流.     

阿米巴肝脓肿36例临床分析

[目的 ]分析阿米巴肝脓肿的临床特点、误诊情况和内外科治疗对患者预后的影响。 [方法 ]采用回顾性调查方法 ,分析 1982年 9月～ 1997年 3月在我院确诊的 36例阿米巴肝脓肿患者的临床特点、诊治和转归情况。 [结果 ]主要临床表现为上腹痛 (86 1% )、发热 (86 1% )、肝肿大伴触痛 (83 3% )和右肋间压痛(5 8 3 % )。实验室检查 ,外周血白细胞升高 (6 1 1% )及血沉增快 (88 5 % )等。 92 6 %的患者血阿米巴抗体阳性。B超声检查 ,单个脓肿及右叶肝脓肿均为 75 %。全部病例均用甲硝唑治疗 ,其中 ,2 7例患者同时行肝脓肿穿刺抽脓。治疗后 ,痊愈 10例 ,显效 2 5例 ,总有效率为 97 2 %。 1例患者死于肝功能衰竭。 [结论 ]单用抗阿米巴药物治疗对于小肝脓肿疗效好 ,如肝脓肿较大应同时行肝脓肿穿刺引流     

The presence of liver auto-antibodies induced by Entamoeba histolytica in the sera from both naturally infected humans and immunized rabbits.

Auto-antibodies against normal human liver have been detected in the sera of humans with highly positive indirect hemagglutination (IHA) amebiasis titers and with clinically-proven amebic liver abscess. Sera of amebiasis patients and rabbits immunized with killed Entamoeba histolytica were tested for anti-amebic antibodies by the IHA test and for auto-antibodies by the complement fixation test, using the antigens prepared from extracts of human liver and rabbit liver. A direct correlation was found to exist between high anti-Entamoeba antibody titers and the presence of anti-liver antibody in the serum. It is proposed that, in addition to direct parasite damage to host tissue, immunological damage could result from the attachment of circulating antigen to the cell surfaces of host tissues such as the liver.