MRI对肝包虫病的诊断价值

目的:探讨肝包虫病的磁共振成像(MRI)特征,评价MRI对肝包虫病的诊断价值。方法:23例经手术病理证实的肝包虫患者,对其术前MRI资料作回顾性对照分析。结果:23例肝包虫诊断正确22例,误诊1例,诊断正确率为95.65%(22/23)。结论:MRI对肝包虫病有较高的诊断价值,可作为CT及B超等影像学检查方法的有效补充。     

IgG subclasses of anti Saccharomyces cerevisiae antibody in inflammatory bowel disease

Elevation of serum anti Saccharomyces cerevisiae antibody (ASCA) has been reported in patients with Crohn's disease. We analysed the subclasses of Immunoglobulin (Ig) G reaction in ASCA in sera from patients with inflammatory bowel disease, healthy controls, and patients with intestinal Behçet's disease. Serum samples were obtained from 29 patients with Crohn's disease, 30 patients with ulcerative colitis, 7 patients with intestinal Behçet's disease, and 12 healthy controls. Serum IgG subclasses IgG1, IgG2, IgG3, and IgG4 of ASCA were analysed using ELISA. IgG4 ASCA was significantly increased in patients with inflammatory bowel disease. In patients with intestinal Behçet's disease, IgG1, IgG3, and IgG4 ASCA were increased. Differential responses, in terms of subclasses in ASCA, were found in patients with inflammatory bowel disease and patients with intestinal Behçet's disease, which may represent different pathophysiologies of these intestinal inflammatory diseases.     

An enzyme-linked immunosorbent assay for the quantitation of IgG anti-D and IgG subclasses in the sera of alloimmunized patients

BACKGROUND: IgG subclass composition of maternal alloantibodies to the D antigen seems to play a role in the severity of hemolytic disease of the newborn.The subclassing of IgG anti-D is usually performed by hemagglutination techniques, but the results are not quantitative and sometimes are difficult to interpret. Thus, there is a need for quantitative methods. STUDY DESIGN AND METHODS: The aim of this study was to develop an enzyme-linked immunosorbent assay (ELISA) for the quantitation of specific IgG anti-D and IgG subclasses in the sera of alloimmunized patients. Group O R1R2 red cells were sensitized with anti-D. Red cell membranes were solubilized with nonionic detergent. IgG and IgG subclasses were measured by a sensitive and reproducible immunocapture ELISA. A serum calibrated for its IgG subclass content was used as a reference, and the anti-D preparation 68/419 was used as an internal control. Optimal conditions for the detection of IgG anti-D and IgG subclasses by ELISA were studied. The absolute concentration and the proportions of IgG subclasses were determined in the sera of 14 pregnant women. RESULTS: A close parallelism was observed between dilutions of the IgG reference serum and the IgG anti-D solubilized from sensitized RBCs. The sum of IgG anti-D subclass concentrations, determined by the ELISA, correlated well with other quantitative methods. CONCLUSION: The method described is sensitive and can be used routinely for the quantitative determination of specific IgG anti-D and IgG subclasses in sera.     

磁共振在IgG4相关性眼病中的诊断价值

目的分析IgG4相关性疾病眼眶受累（IgG4-ROD）的磁共振表现,探讨其诊断价值。方法回顾性分析18例IgG4-ROD患者MR图像,分析MR图像病变部位、双侧还是单侧、形状、边缘、眶内结构、T1WI及T2WI信号特点及强化方式。结果18例IgG4-ROD病例全部经手术病理检查证实,根据MR表现分为4类：泪腺型、眼外肌型、肿块型、弥漫型。6例（33.3%）表现为泪腺增大,其中4例双侧对称增大,2例单侧增大;7例（38.9%）表现为肌锥内外软组织肿块,其中2单发,5例多发;1例（5.56%）眼外肌增粗;4例（25%）表现为沿邻近颅底孔道、生理腔隙及三叉神经走行区弥漫病变。18例中8例可见看到眶下神经增粗。14例行动态增强检查,时间-信号曲线均表现为快速上升缓慢流出的Ⅱ型曲线。结论IgG4-ROD会累及泪腺、眼外肌、内眦、肌锥外间隙等,眶下神经增粗和沿三叉神经分支浸润性生长是该病特征性表现,认识了解IgG4-ROD典型影像学表现,对诊断提高诊断率有帮助。     

曲霉IgG抗体检测在血液病/恶性肿瘤患者侵袭性肺曲霉病中的诊断价值

目的 评价曲霉IgG抗体检测在血液病/恶性肿瘤患者侵袭性肺曲霉病(IPA)的诊断价值,为血液病/恶性肿瘤患者IPA的诊断提供新的检测方案.方法 回顾性研究.收集中国医学科学院血液病医院检验科2018年1月至2021年9月临床诊断IPA患者24例作为疾病组,临床排除IPA患者35例作为对照组.用ELISA法检测血清曲霉半...     

IgG及IgG指数在中枢神经系统疾病中的诊断价值

目的探讨IgG和IgG指数变化在中枢神经系统疾病中的诊断意义。方法收集77例中枢神经系统疾病患者和27例健康对照组的血清／脑脊液配对标本,用BNP特种蛋白分析仪,采用免疫散射比浊法分别测定脑脊液清蛋白（CALB）、脑脊液IgG（CIgG）、血清IgG（SIgG）,用0LYMPUS2700全自动生化分析仪采用溴甲酚绿法测定血清清蛋白（SALB）,将其结果套入相应公式换算CALB／SALB的比值（QALB）及IgG指数。结果化脓性脑膜炎与结核性脑膜炎组QALB、CIgG均明显增高与健康对照组差异有统计学意义（P〈0．05）,IgG指数与健康对照组差异无统计学意义（P〉0．05）;病毒性脑膜炎组QALB、CIgG、IgG指数均增高与健康对照组差异有统计学意义（P〈0．05）;多发性硬化组QALB无明显增高,与健康对照组差异无统计学意义（P〉0．05）,而CIgG、IgG指数明显增高,与健康对照组的差异有统计学意义（P〈0．05）;格林-巴利综合征QALB、CIgG均明显增高,与健康对照组差异有统计学意义（P〈0．05）,IgG指数与健康对照组差异无统计学意义（P〉0．05）。结论QALB、CIgG及IgG指数可以了解血脑屏障损伤程度及脑脊液中IgG的来源,对中枢神经系统疾病诊断、治疗及预后具有重要意义。     

抗环瓜氨酸肽抗体的定量检测在类风湿性关节炎诊断中的应用

目的探讨抗环瓜氨酸肽(CCP)抗体在类风湿性关节炎(RA)中的诊断意义.方法采用酶联免疫吸附法(ELISA)定量检测抗CCP抗体相对浓度,采用免疫散射比浊法定量检测类风湿因子(RF)浓度,并比较抗CCP抗体与RF的相关性.结果抗CCP抗体在RA诊断中其敏感性较RF低(P＜0.05),特异性较RF高,有显著性差异(P＜0.01),抗CCP抗体联合检测在诊断RA时,能使敏感性提高到86.7%,特异性提高到98.6%.结论抗CCP抗体对RA具有很高的特异性,尚不能认为与RF具有相关性.因此,两者联合检测能提高RA血清学的阳性率.     

抗环瓜氨酸肽抗体的定量检测在类风湿性关节炎诊断中的应用

目的 探讨抗环瓜氨酸肽(CCP)抗体在类风湿性关节炎(RA)中的诊断意义。方法 采用酶联免疫吸附法(ELISA)定量检测抗CCP抗体相对浓度，采用免疫散射比浊法定量检测类风湿因子(RF)浓度，并比较抗CCP抗体与RF的相关性。结果 抗CCP抗体在RA诊断中其敏感性较RF低(P＜0．05)，特异性较RF高，有显著性差异(P＜0．01)，抗CCP抗体联合检测在诊断RA时，能使敏感性提高到86．7％，特异性提高到98．6％。结论 抗CCP抗体对RA具有很高的特异性。尚不能认为与RF具有相关性。因此，两者联合检测能提高RA血清学的阳性率。     

Specificity of counterimmunoelectrophoresis with an arc-5 antigen for the diagnosis of cystic hydatid disease

A rapid and simple counterimmunoelectrophoresis (CIEP) on a cellulose acetate membrane with antigen that elicits an arc-5 precipitin line in immunoelectrophoresis (IEP) is sensitive for the diagnosis of cystic hydatid disease (CHD). Specificity was proven by assaying the sera of patients with amoebiasis, schistosomiasis, filariasis, infections due to a variety of soil-transmitted nematodes and Taenia solium cysticercosis. Other sera analysed were from healthy controls, and patients with malignancies and conditions in which a space-occupying mass or lesion was presumed to be a hydatid cyst on ultrasound (US) and/or computerized tomography (CT). Compared to the indirect haemagglutination (IHA) test, the CIEP was almost 100% specific.     

类风湿关节炎患者血清IgG及亚类的水平和临床意义

目的探讨类风湿关节炎(RA)患者血清IgG及亚类的水平和临床意义。方法选择2018年10月至2019年6月该院风湿免疫科收治的RA患者54例纳入RA组,选择同期36例健康体检者纳入对照组。采用双抗体夹心法ELISA检测血清IgG亚类水平;采用免疫散射比浊法检测免疫球蛋白(IgG、IgA、IgM)、补体(C3、C4)和类风湿因子(RF)水平;采用流式点阵免疫发光法检测抗环瓜氨酸肽(CCP)抗体水平。比较两组各检测指标水平,分析RA患者血清IgG亚类与IgG、IgA、IgM、C3、C4、RF及抗CCP抗体之间的相关性。结果RA组血清IgG、IgA、RF和抗CCP抗体水平显著高于对照组(P<0.05),但IgM、C3和C4水平差异无统计学意义(P>0.05)。RA组血清IgG1和IgG3水平显著高于对照组(P<0.05),两组血清IgG2和IgG4水平差异无统计学意义(P>0.05)。与对照组比较,RA组IgG1/IgG和IgG3/IgG显著升高(P<0.05),而IgG2/IgG显著下降(P<0.05)。Spearman相关分析显示,RA组患者血清IgG1水平与IgG呈高度正相关(r=0.865,P<0.05);IgG2、IgG3水平与IgG均呈中度正相关(r=0.613、0.644,P<0.05);IgG4水平与IgG呈低度正相关(r=0.271,P<0.05);IgG2水平与IgA呈低度正相关(r=0.399,P<0.05);IgG3水平与IgM呈低度正相关(r=0.343,P<0.05)。IgG各亚类与RF、抗CCP抗体之间均无相关性(P>0.05)。结论RA患者血清IgG水平显著升高,并且存在IgG亚类水平变化。IgG亚类检测对RA早期诊断价值有限。     

抗环瓜氨酸肽抗体对类风湿性关节炎的诊断价值

目的探讨抗环瓜氮酸肽抗体（抗-CCP）对类风湿性关节炎（RA）诊断的临床价值。方法采用酶联免疫吸附试验法和乳胶增强比浊法分别测定155例RA、178例非RA和100例健康人的血清抗-CCP和类风湿因子（RF）,并比较抗～CCP和RF的灵敏度、特异度、阳性预期值和阴性预期值。结果抗-CCP和RF的灵敏度分别为63．2％和59．1％,特异度分别为95．0％和81．6％,阳性预期值分别为87．5％和64．3％,阴性预期值分别为82．2％和58．2％。抗-CCP阳性率在RF阴性的RA患者中为34．9％,抗-CCP阳性的RA患者有较高的C反应蛋白浓度和较多的关节肿胀,并且抗-CCP与患者的关节损伤率有一定的相关性,但是抗-CCP与DAS28评分之间无相关性。结论与RF相比,抗-CCP对诊断RA有较好的临床价值,并与影像学检查有一定的相关性。     

自身免疫性疾病和慢性肝病IgG4增高者血清IgG4／IgG分析

目的：探讨自身免疫性疾病和慢性肝病IgG4增高者血清中IgG4／IgG二组差异,并与健康人群进行比较。方法收集上海市仁济医院南院门诊和住院的自身免疫性疾病患者血清25例,慢性肝病患者伴IgG4增高者血清49例,以健康体检者血清30例作为对照组。利用免疫散射比浊法分别检测上述三组患者血清IgG4和IgG水平,计算IgG4与IgG比值,并分析三组之间血清IgG4水平和IgG4／IgG值的差异。结果与对照组相比,自身免疫性疾病组和慢性肝病伴IgG4增高组IgG4水平均显著升高,IgG4／IgG值均显著升高（P＜0．05）。与慢性肝病伴IgG4增高组相比,自身免疫性疾病组IgG4水平和IgG4／IgG值均显著升高（P＜0．05）。结论本文结果显示自身免疫性疾病患者和慢性肝病伴IgG4增高患者IgG4与IgG水平并非成一定比例增高,IgG4具有含量和比例增高现象,说明IgG4单项检测和IgG4／IgG检测对鉴别自身免疫性疾病和慢性肝病具一定临床价值。     

Immunoglobulins in hemophilia: correlation between IgG subclasses, IgE and HIV antibody

Twenty-two patients with hemophilia who had received factor VIII concentrate were evaluated. Only 12 of 22 were seropositive for HIV. Elevation of IgG, IgG1, IgM and IgE was not related to HIV seropositivity. Means of IgG1, IgG2, and IgG3 were significantly higher in patients with elevated IgG. Means of IgG2 and IgG3 were significantly lower in patients with elevated (greater than or equal to 251) serum IgM. Seven of the 22 patients demonstrated elevated (greater than or equal to 100) serum IgE; mean serum IgA was significantly lower, though in normal range, in these seven patients. Alterations in serum immunoglobulins in patients with Hemophilia are frequently seen, however, like other immune-dysfunction in these patients, these abnormalities can not be attributed to their HIV status.     

血清甲状腺球蛋白抗体、甲状腺微粒体抗体、甲状腺过氧化物酶抗体对自身免疫性甲状腺疾病的诊断价值

目的探讨血清甲状腺球蛋白抗体（TGAb）、甲状腺微粒体抗体（TMAb）、甲状腺过氧化物酶抗体（TPOAb）对自身免疫性甲状腺疾病（AITD）的诊断价值。方法100例甲状腺功能异常患者根据血清中三碘甲状腺原氨酸（B）、甲状腺素（Td）、促甲状腺激素（TSH）水平分为甲亢组和甲减组,每组50例;另选择50例甲状腺功能正常人群作为对照组。各组患者均采集静脉血5mL,分离血清,放射免疫法测定患者血清中TGAb、TMAb、TPOAb、L、T4、TSH水平。观察各组患者血清中TGAb、TMAb、TPOAb阳性率;比较各组TGAb、TMAb、TPOAb阳性患者血清水平。结果甲亢组和甲减组血清TPOAb阳性率均明显高于血清TGAb、TMAb阳性率;甲亢组、甲减组患者血清TGAb、TMAb、TPOAb阳性率均明显高于对照组;甲减组患者血清TGAb、TMAb、TPOAb阳性率均明显高于甲亢组。甲亢组和甲减组患者血清TGAb、TMAb、TPOAb水平均明显高于对照组。甲减组患者血清中TGAb、TMAb、TPOAb水平均明显高于甲亢组。结论TPOAb在AITD的诊断中具有重要意义,为AITD的诊断、治疗及预后评估提供了重要依据。     

早期类风湿性关节炎患者血清抗突变型瓜氨酸波形蛋白抗体的水平变化意义

目的探讨血清抗突变型瓜氨酸波形蛋白（MCV）抗体水平在诊断类风湿性关节炎（RA）中的意义。方法用酶联免疫吸附试验（ELISA）测定73例RA患者血清抗MCV抗体水平,并同步分别应用ELISA、放射免疫分析法及增强比浊法检测抗环瓜氨酸多肽（CCP）抗体、肿瘤坏死因子α（TNF-α）和类风湿因子（RF）水平,与35例非RA患者和40名健康体检者进行对照比较。结果RA组血清抗MCV抗体水平显著高于健康对照组（P〈0.01）;非RA组与健康对照组间差异无统计学意义。抗MCV抗体对RA诊断的敏感性为83.56%（61/73）,特异性为96.00%（72/75）,均高于抗CCP抗体及RF;相关分析显示RA患者抗MCV抗体水平与抗CCP抗体、TNF-α及RF呈显著正相关（r=0.531、0.243、0.347,P均〈0.01）。结论抗MCV抗体与RA联系密切,为一高度敏感的、新的RA标记物,临床上检测血清抗MCV抗体水平对于筛查和辅助早期诊断RA具有重要意义。     

抗MDA5抗体对成年及幼年型皮肌炎合并间质性肺病诊断效能的meta分析

目的通过meta分析探究抗黑色素瘤分化相关基因5(MDA5)抗体对不同类型皮肌炎(DM)并发快速进展型间质性肺病(RPILD)及慢性间质性肺病(ILD)的诊断效能。方法检索Pub Med、Embase、Cochrane library、中国知网、万方、维普和中国生物医学文献数据库,时间起止为建库至2017年5月。运用Meta-disc1.4行异质性检验,计算汇总敏感度、特异度、诊断比值比、阳性阴性似然比和SROC曲线。采用QUADAS-2和stata 12.0进行质量评价和发表偏倚。结果共纳入32篇研究,文献质量较高,各部分不存在高偏倚风险,为中等异质性。抗MDA5抗体对成年DM合并RPILD的诊断效能(AUC=0.927,Q*=0.862)优于对成年DM合并慢性ILD(AUC=0.717,Q*=0.667)、幼年型皮肌炎(JDM)合并RPILD(AUC=0.836,Q*=0.768)的诊断效能。抗MDA5抗体对DM合并RPILD诊断准确性:临床无肌病型皮肌炎(CADM)(AUC=0.942,Q*=0.880)高于DM(AUC=0.926,Q*=0.860),亚洲(AUC=0.960,Q*=0.891)优于中国(AUC=0.925,Q*=0.859)及欧美人群(AUC=0.928,Q*=0.863),ELISA法(AUC=0.929,Q*=0.864)不劣于免疫沉淀法(AUC=0.927,Q*=0.859)。Deek's漏斗图提示不存在发表偏倚。结论抗MDA5抗体诊断成年及幼年型DM合并ILD有较高敏感性和特异性。     

Profiles of brucella-specific immunoglobulin G subclasses in sera of patients with acute and chronic brucellosis

Serum specimens from patients with acute brucellosis (164), chronic brucellosis (22) and controls (75) were tested by ELISA for brucella-specific IgG, IgM, IgA and subclasses of IgG1 to 4 antibodies, Rose Bengal antigen slide agglutination (RB) and microagglutination (MA) tests. The RB and MA showed similar results and were positive in 100% and 64% of specimens from patients with acute and chronic brucellosis respectively. ELISA IgG and IgA were positive in sera from all patients with brucellosis while IgM was positive in 100% and 32% of specimens from patients with acute and chronic brucellosis respectively. Elevated IgG subclasses to brucella antigen were found in different proportions in the sera of patients with acute and chronic brucellosis. In patients with acute brucellosis, IgG1 was the predominant response (79%) followed by IgG3 (58%), IgG2 (36%) and IgG4 (14%). In contrast, IgG4 was the predominating subclass response (73%) in patients with chronic brucellosis followed by IgG1 (41%), IgG2 and IgG3 (27% each). When considering the most common elevated IgG subclasses, in each serum, either alone or in combination with each other, patients with acute brucellosis showed IgG1+IgG3 (24%), IgG1 (19%), IgG1+IgG2+IgG3 (16%) while patients with chronic brucellosis showed IgG4 (27%) and IgG1+IgG2+IgG3+IgG4 (18%). This study reveals that in addition to the difference in brucella-specific Ig class response in patients with acute (IgG, IgM, IgA) and chronic (IgG, IgA) brucellosis, the profiles of IgG subclasses are different where IgG1 predominates in the acute and IgG4 in the chronic stages of the disease.     

Detection of salivary and seric IgG and IgA antipooled pigeon sera activities in patients with pigeon breeder's disease

Pigeon breeder's disease (PBD) is an interstitial lung disease induced by exposure to pigeon antigens. Search of antipigeon antigen antibodies (APSA) in serum or bronchoalveolar lavage is generally used for auxiliary diagnostic purposes. However, APSA can be present in a number of exposed but asymptomatic individuals as well as in patients with other interstitial lung diseases who live in areas where keeping pigeons is a common domestic habit. In this study, saliva was evaluated as an alternative means to serum for APSA detection by ELISA using pooled pigeon sera as antigen. Serum and saliva samples obtained from 17 patients with PBD, 14 with idiopathic pulmonary fibrosis (IPF), 19 asymptomatic relatives (AR) exposed to pigeon antigens, and 27 clinical healthy voluntary subjects (CHVS) were tested for IgG and IgA APSA. Our results showed that both fluids obtained from PBD patients exhibited a significantly higher specific IgG antibody activity compared to the other groups. Serum optical density (O.D.) values for PBD were 1.187 ± 0.738 vs. 0.024 ± 0.033, 0.255 ± 0.471, and 0.204 ± 0.346 for CHVS, AR and IPF, respectively (P < 0.05). Salivary O.D. for PBD were 0.801 ± 0.447 vs 0.010 ± 0.011, 0.104 ± 0.151, and 0.22 ± 0.447 (P < 0.05). In contrast, serum specific IgA did not discriminate between PBD and IPF patients. In addition, although the PBD group exhibited the highest values of IgA salivary APSA, high levels were also observed in saliva specimens from CHVS, a group of normal individuals who deny pigeon exposure. These findings suggest that measurement of IgG salivary APSA can play a role in the evaluation process of patients with pigeon breeder's disease. © 1996 Wiley-Liss, Inc.