甲型肝炎病毒感染者抗—HAVIgM与类风湿因子检测及探讨

<正> 检测病人血清中HAV—IgM抗体这是目前诊断甲型肝炎最可靠最灵敏的方法,患者于发病后1～4周血清中即可检出HAV—IgM抗体,该特异性抗体主要有两种,即IgM和IgG型的抗—HAV,HAV—IgM抗体在急性甲肝感染时出现较早上升较快,高峰滴度较高、持续时间较短。故凡HAV—IgM抗体阳性特别是滴度较高(>10~(-3))时常提示为急性HAV感染或复发。我们在检测甲型肝炎病毒IgM抗体时发现大多数甲型肝炎患者血清中存在类风湿因子(RF)常干扰HAV—IgM抗体的检测,导致假阳性结果。为此通过对甲型肝炎患者RF检测试图了解RF与肝功能以及RF对抗—HAVIgM检测等的影响。     

甲型肝炎早期实验诊断的研究

以人胚肺二倍体细胞分离出的甲型肝炎病毒作抗原,以马抗人IgM经纯化后的抗体为捕捉抗体,以纯化甲型肝炎恢复血清为特异性抗体,过碘酸钠法标记酶,以OPD为底物制成抗-HAV IgM诊断试剂盒,建立了ELISA捕捉法检测抗-HAV IgM,结果:甲型肝炎暴发点84例均为阳性,流行性出血热及健康成人各30例均为阴性。322例急性黄疸型肝炎住院患者中192例阳性(占59.6%)。12例第一病日患者11例阳性(占91.6%),证明该方法对甲型肝炎早期诊断有重要价值。     

流行性乙型脑炎急性期特异性IgM抗体检查应用于早期诊断的初步探讨

1.实验证明乙脑病人在病后4～8天大多数可查到 IgM 特异性抗体。2.17例双份血清抗体有4倍增长的乙脑患者,急性期单份血清查 IgM 抗体,可以作出诊断的有14例,占82%。3.急性期单份血清查到 IgM 抗体的有22例,其中21例双份血清血抑抗体有2～4倍增长,1例双份血清血抑抗体不增长,但补体结合抗体却有4倍以上增长。4.本文对国产2-ME 和71℃加温法代替进口2-ME 用于乙脑早期诊断的可能性进行了研究和讨论。5.实验观察到病情越重的病人,急性期血抑抗体滴度较低。     

固相酶标记双夹心法检测甲型肝炎IgM抗体

血清学方法用于传染病诊断,往往需要检测双份血清。后期抗体滴度比前期有4倍以上升高时,判为阳性。此法繁复,又不能用于早期诊断。IgM 抗体出现于新感染的早期,检测早期血清中的特异性 IgM 抗体,应可避免上述缺点。Duermeyer 等首先用固相酶标记双夹心法检测甲型肝炎(下称甲肝)IgM 抗体,以后又陆续有所报道。本文目的在于简化其检测技术,并对应用价值作出评价。     

病毒性肝炎的临床病毒血清学诊断

近年来病毒血清学技术的发展,RIA与ELISA技术日益广泛应用,肝炎病毒血清学知识不断丰富,现在已可能从单份血清的多项目检测,对肝炎类型的确定,病期与传染性的估计,预后的判断,作出较为合理、准确的判断。由于甲型肝炎在临床起病后,粪便中排出病毒迅速减少至停止;病毒血症期十分短暂、滴度低;没有慢性携带病毒状态,这几种原因使病毒不易被检出。检测甲型肝炎病毒作为临床诊断的手段,不是切实可行的。特异性甲型肝炎抗体(抗-HAV)在急性感染早期,滴度已相当高,恢复期后仍然长期存在。因此,血清中检出抗-HAV不一定就是急性感染。必须通过双份血清的检测,证明抗-HAV滴度有4倍或以上的增长,才能认为是急性感染。可是,要达到这个诊断条件,双份血清常须相隔4周以上,对甲型肝炎早期临床诊断的帮助不太大。然而,甲型肝炎正如许多病毒性疾病一样,在临床起病时,血清中首先出现的是IgM     

流行性乙型脑炎流行期ELISA法检测猪抗体的研究

在流行性乙型脑炎(乙脑)流行前期和流行期分别采集固定饲养的10头猪的血清,测定其ELISA IgM抗体滴度,同时与HI抗体滴度作了比较。流行前期ELISA IgM抗体小于10~3(150～320),HI抗体滴度为阴性(<1:10)。当开始出现HI IgM抗体时,ELISA IgM抗体滴度已大于10~4,此抗体约持续2周,2周后又下降至10~3左右,但HI抗体大部为IgG型。对某猪场定期每次各检测20头猪,在非流行期(4月)和流行前期(7月7日～8月4日)的ELISA IgM抗体均小于10~3,当进入流行期(8月11日后)HI IgM抗体阳性时,ELISA IgM抗体即大于10~4。猪群ELISA IgM抗体可持续约1个月。     

酶联免疫吸附试验检测人血清弓形体IgG、IgM抗体的研究

对ELISA检测人血清弓形体IgG、IgM抗体进行了研究。450份孕妇血清中,ELISA阳性率显著高于IHA;抗体滴度分析,ELISA一般高于IHA2～10倍。25份ELISA IgG抗体阳性血清,TFA检出19份;3份IgM抗体阳性和2份IgG、IgM抗体均阳性血清,IFA分别检出2份。2份阴性和4份含不同抗体滴度的阳性血清于第一次测定后,第7天和第21天测定的阴、阳性结果一致,OD值变异系数为2.43～16.52%。39份阳性血清抗体滴度与OD值呈直线比例关系(r=0.991,p<0.0005)。结果表明,ELISA用于弓形体感染的血清学诊断具有较好的实用性。     

急性甲型肝炎与急性戊型肝炎临床对比分析

目的 研究急性甲型、戊型肝炎的发病情况，进行二者一临床对比分析。方法 本组研究对象为427例急性肝炎患者（甲型肝炎227例、戊型肝炎200例），用酶联免疫吸附法分别检测二组患者血清的抗HAV-IgM和HEV-IgG，部分进行了动态观察，并对其肝功能项目（ALT、AST、BIL、AKP）同时进行了检测。结果 甲型肝炎患者在各年龄段均有发病，39岁以下青少年患者约占72．7％。戊肝患者发病年龄一般在10岁以上，中老年组戊肝发病率较高。二组患者在病程3个月左右血清抗体滴度明显下降，甲、戊二型肝炎的下降幅度分别为2～16倍和4～16倍。二组患者均有ALT、AST、BIL、AKP升高及不同程度的肝功能损害。甲型肝炎患者AKP值明显高于戊型肝炎组。结论 二型肝炎患者发病年龄分布存在一定差异。甲型肝炎IgM抗体滴度下降稍慢，与甲乙、甲丙等重鸯感染及近期感染有关。对戊型肝炎的预防和治疗应引起高度重视。     

四种流行性乙型脑炎血清学诊断方法的评价

流行性乙型脑炎(下称乙脑)患者的血清学诊断,以往主要用补体结合(CF)和血凝抑制(HI)试验,偶尔也用中和试验,这些试验主要是以恢复期血清抗体滴度比急性期抗体滴度增高4倍或4倍以上为诊断依据,故多作回顾性诊断,不能满足临床早期     

间日疟间接荧光抗体试验观察者变异与正常值上限研究

将间日疟阳性血清作系列倍比稀释进行间接荧光抗体试验,不同观察者平行读数或同一观察者先后读数的终点滴度之变异在一个倍比稀释度之内。对无疟疾感染史的正常人群522份血清作间日疟间接荧光抗体试验,其荧光抗体滴度正常值上限按99%位点估计为<1:10。     

Application of Monoclonal Antibodies against Epidemic Hemorrhagic Fever Virus in Early Clinical Diagnosis and in Viral Antigen Analysis

Indirect fluorescent antibody test (IFAT) was employed to detectviral antigens in the peripheral blood lymphocytes from 77 patients withclinically diagnosed epidemic hemorrhagic fever (EHF). The positive ratewas 50.7%, and it was 64.3% (27/42) for early cases (2nd to 5th day ofdisease). It was found that the earlier and the more severe the cases were,the higher the positive rate was. Three McAbs, 4B9, 4E7 and 3H4 havebeen introduced to IFAT. Five reaction patterns of the three McAbs withviral antigen positive cases were observed. The McAbs showed theirdifferences in respect of positive rate. Combination of McAbs could raisethe positive rate. In the cases of early phase with positive EHFV antigensin the leucocytes, the positive rate of specific IgM in acute phase sera was96.3%. The positive rate and accuracy of EHF early diagnosis could beraised by combined application of detection of the viral antigens andspecific serum IgM in the acute phase.     

ELISA检测脐血中巨细胞病毒IgM抗体诊断先天性巨细胞病毒感染的探讨

作者用直接和间接ELISA方法,对成都市6所医院初生婴儿582例的脐应进行了巨细胞病毒(CMV)IgM抗体检测。结果:两种方法检出CMV IgM抗体阳性者共27扮,阳性率4.6％,其中用直接ELISA检测,阳性者25份,间接ELISA阳性者为15份。前者明显优于后者(P<0.05),表明其敏感性高,特异性强。CMV IgM抗体阳性儿临床随访至5～6月龄,2例听力异常,1例眼底可疑异常。     

ELISA检测脐血中巨细胞病毒IgM抗体诊断先天性巨细胞...

Cytomegalovirus IgM (CMV IgM) antibodies of 582 cord sera from 6 hospitals in Chengdu were detected by direct ELISA and indirect ELISA. Twenty-seven cases with CMV IgM antibody positive were detected from 582 cord sera. Twenty-five and 15 cases were found to have CMV IgM antibody by direct ELISA and indirect ELISA, respectively (P greater than 0.05). Indirect ELISA for detection CMV IgM antibody was only interfered by high concentration of CMV IgG and rheumatoid factor. Children with CMV IgM antibody positive were followed-up to 5-6 months. Hearing loss was detected by impedance audiology in only 2 cases. But the other physical and mental examinations were normal. The result showed that the prevalence of congenital CMV infection is 4.6% in our study and direct ELISA method is more specific and sensitive than indirect ELISA method to detect CMV IgM antibody in cord serum.     

SEROEPIDEMIOLOGIC STUDY OF EPIDEMIC HEMORRHAGIC FEVER WITH RENAL SYNDROME IN CHINA

Sera from 193 cases of epidemic hemorrhagic fever renal syndrome (EHFRS) and 173 normal persons and patients with other diseases in endemic and nonendemic areas were examined for immunofluorescent (IF) antibodies to Korean hemorrhagic fever (KHF) antigen by indirect immunofluorescent antibody (lFA) test. 76 0f 78 (97.4470) paired sera from EHFRS patients were KHF' antibody positive in l or both samples. Of 109 acute stage sera samples 81 (74.31To) were KHF IgM antibody positive whereas of 162 con- valescent sera samples 156 (96.2970) were KHF IgG antibody positive, indicating that the EHFRS agent is immunologically related, if not identical with KHF. The earliest date of IF IgM antibody ap- pearance was l day after onset of illness a.nd IF IgG antibodies could be found in the patient convalescent serum 16 years after the acute at- tack. There was no immunologic relationship between the EHFRS agent and Japanese B en- cephalitis (JBE) or influenza A3 viruses.     

旋毛虫感染早期兔血清中IgM的检测

目的探讨斑，点酶联免疫吸附试验（Dot-ELISA）检测旋毛虫感染早期免血清中特异性抗体IgM在免疫诊断上的价值。方法正常家免经口灌入旋毛虫肌肉期幼虫，于感染后d7和d14静脉系血分离血清，以Dot－ELISA法检测血清中的IgM。结果感染后d7和d14旋毛虫特异性抗体IgM的阳性率分别为85．7％和100％，最高滴度可达1：6400，且与日本血吸虫和弓形虫无交叉反应。结论Dot－ELIS法检测旋毛虫特异性抗体IgM对旋毛虫感染早期诊断具有特异性较强、敏感性高、重现性好的优点．     

流行性出血热病毒单克隆抗体在临床早期诊断中应用的研究

用IFAT检测77例临床诊断为EHF病人的外周血白细胞中的病毒抗原。阳性率为50.6％。2—5病日的早期病人阳性率为64.3％(27/42)。并发现,病日越早,病情越重,阳性率越高。试验中应用了抗EHF病毒McAb4B_9、4E_7、3H_4株。抗原阳性者对3种McAb的反应表现为5种类型。不同McAb对抗原的检出率不同,混合使用McAb可提高阳性检出率。在EHF病毒抗原阳性早期患者中,急性期血清特异性IgM抗体阳性率为96.3％。若联合检测EHF病毒抗原和急性期血清IgM抗体,可提高早期诊断的阳性率和准确性。     

抗戊型肝炎病毒开放读码框架及IgM和IgG抗体的消长规律及临床意义

目的研究戊型肝炎病人抗戊型肝炎病毒（ＨＥＶ）开放读码框架２（ＯＲＦ２）和３（ＯＲＦ３）及ＩｇＭ和ＩｇＧ抗体的消长规律及其临床意义。方法采用ＨＥＶＯＲＦ２、ＯＲＦ３合成多肽单独和联合酶联免疫法,动态检测５２例病人血清抗ＨＥＶ。结果起病初期ＯＲＦ２抗体和ＯＲＦ３抗体水平均较高,随病程的延长两者均下降,ＯＲＦ３抗体尤为明显。联合检测ＯＲＦ２和ＯＲＦ３抗体可提高试验的敏感性。血清抗ＨＥＶＩｇＭ和抗ＨＥＶＩｇＧ阳性率于起病半个月内分别为７１．１％（３２／４５）和９７．８％（４４／４５）,随病程的延长抗ＨＥＶＩｇＭ较早阴转。结论ＨＥＶ抗体诊断试剂盒至少应含有ＯＲＦ２和ＯＲＦ３两种抗原。抗ＨＥＶＩｇＭ的特异性好而抗ＨＥＶＩｇＧ的灵敏度高。     

班氏丝虫病人治疗前后血清特异性抗体的观察

用马来丝虫成虫冰冻切片抗原IEST法,观察了班氏丝虫病人未经治疗者107例、治后1年微丝蚴阴转者35例和治后3年者112例血清IgG、IgE和IgM抗体水平及其变化,结果表明:未经治疗的病人,IgG抗体阳性GMRT116.6最高,IgE37.1次之,IgM31.0最低;其阳性率分别为96.3%,86.9%和88.8%。经有效治疗后1年,IgG抗体阳性反应者仍有85.7%,而IgE和IgM抗体水平呈现大幅度下降,治后阳性率均下降到28.6%,接近治后3年者IgE、IgM抗体的低水平,说明IgE、IgM抗体对疗效反应敏感,选择检测IgE或IgM抗体作为疗效考核的指标优于检测IgG抗体。此外,丝虫病人血清IgG、IgE和IgM抗体的阳性率和阳性GMRT与微丝蚴密度无相关性。     

A clinical study of cytomegalovirus infections during pregnancy

Summary Enzyme-linked Immunosorbent Assay (ELISA) was adopted to detect the human cytomegalovirus (HCMV) specific IgG, IgM in the blood samples of 216 pregnant women and the umbilical cord blood, as well as the HCMV antigen in the urine specimens of 91 newborn infants. Emphasis was put on the occurrence of cytomegalovirus infection during pregnancy and influence on both the mother and the infant. Our experimental results showed that HCMV IgG positive rate in the maternal sera as well as in cord sera was 93.98%; HCMV IgM positive rates were 8.8% in maternal sera and 3.7% in cord sera, respectively. In maternal sera IgG-positive group, 31.6% cord sera showed also HCMV IgG positive results. In 91 urine specimens of newborn infants, HCMV-Ag positive specimens accounted for 10.98% (10 cases). The rates of abortion, congenital malformation, stillbirth, premature fetal death, and intrauterine growth retardation (IUGR) were all apparently higher in the HCMV-IgM positive pregnant group than in the HCMV-IgM negative group. The infants of HCMV-IgM positive mothers also showed lower birth weight, height, biparietal diameter, suboccipitobregmatic diameter, occipitofronatal diameter, occipito-mental diameter than the infants of HCMV-IgM negative mothers. Meanwhile, the growth and development indices of the former showed a tendency to decrease. Placenta histological examination showed thac HCMV-IgM positive group had a higher incidence of pathological changes than HCMV-IgM negative group. Altogether, there were 8 cases of cogenital infections.     

逆转录聚合酶链反应及酶联免疫吸附试验在诊断肾病综合征出血热中的价值

寻找一种快速、敏感、特异的诊断肾病综合征出血热 (HFRS)方法。方法　采用碘化钠 -异硫氰酸胍 -氯仿法抽提病毒核酸 ,逆转录聚合酶链反应 (RT-PCR)检测不同病程中 HFRS患者血清中的汉坦病毒感染情况 ,并采用间接酶联免疫吸附试验 (EL ISA)检测特异性 Ig M抗体。结果　 84.7%患者血清中汉坦病毒核酸检测为阳性 ,其中病程为 1周内者检出率为 10 0 % ,1～ 2周者为 6 0 % ,超过 2周者为 33.3% ,而特异性 Ig M的总检出率为 70 .0 5 % ,病程在 1周、1～ 2周、超过 2周者检出率分别为 6 4%、90 %、6 6 .6 %。结论　RT-PCR和 ELISA都是 HFRS的特异性诊断方法 ,两者可相互补充 ,提高诊断率