肾综合征出血热的流行特征及临床分型

1.病型及地区分布本病主要分布在亚洲的东部、北部和中部地区,包括日本(城市型及实验动物型均为大鼠型HFRSV引起)、朝鲜(城市型、野鼠型、实验动物型)、苏联远东滨海区(野鼠型)及我国(野鼠型、家鼠型、实验动物型),正常人群血清中发现HFRS血清型病毒抗体的地区遍及世界各大洲,许多国家和地区沿海港口城市的大鼠(多为褐家鼠)自然携带HFRSV抗原及/或抗     

白城市洮北区首例肾综合征出血热流行病学调查

目的：核实诊断肾综合征出血热(HFRS)临床病例、疫情，确认疫源地，查找疫源动物。方法：运用了流行病学横断面调查方法。结果：在疫点内调查30人，其中5人HFRS IgG抗体阳性，隐性感染率为16．67％。捕到褐家鼠19只，其中2只HFRS病毒抗原阳性，带毒率为10．53％。结论证实白城市HRFS 临床病例及疫情存在，可以确认家鼠型HFRS疫源地。     

应重视肾综合征出血热的特殊临床表现和早期诊断线索

肾综合征出血热（HFRS）在我国又称流行性出血热,简称出血热,是由汉坦病毒引起的一种自然疫源性疾病,啮齿类动物特别是鼠类为其自然宿主和主要传染源。世界上有30多个国家发现HFRS,我国是HFRS流行最严重的国家,每年发病人数占世界汉坦病毒感染病例的90％以上。我国大陆除青海省与新疆维吾尔自治区外,各省、自治区、直辖市均有病例发生,台湾也有汉坦病毒感染病例报道。本病在我国主要分为姬鼠型和家鼠型两种类型,其中黑线姬鼠、黄颈姬鼠和大林姬鼠为姬鼠型出血热的主要宿主动物和传染源;褐家鼠为家鼠型出血热的主要宿主动物和传染源。目前我国存在姬鼠型、家鼠型和家鼠姬鼠混合型3种疫区,20世纪90年代以来,家鼠型疫区逐渐扩大,而且正在发生部分姬鼠型疫区向混合型疫区、混合型疫区向家鼠型疫区演变。     

福建省鼠间肾综合征出血热流行病学调查

目的掌握福建省鼠间肾综合征出血热(HFRS)流行情况和疫源地分布,为控制HFRS的流行提供参考。方法根据福建省啮齿动物地理区划以及肾综合征出血热病例分布状况,选择18个县、市作为调查地区,用笼夜法捕鼠采集血清标本,用双抗原夹心ELISA法检测血清中抗汉坦病毒(Hantan virus,HV)抗体,分析鼠间HFRS流行情况。结果各个地区HV宿主动物种类分布不均衡,但以褐家鼠为主要宿主动物,其次为黄胸鼠,野外鼠密度较低。褐家鼠抗体阳性率最高,达到9.89%。各个地理区划中II区即闽东山地抗体阳性率最高,为9.32%,而III区即闽中、闽西南山地抗体阳性率最低,为2.74%。调查点中泰宁、周宁、福鼎、厦门、福清、莆田、平潭等地鼠血清HV抗体阳性率均超过10%。而上杭、漳平、漳浦、安溪等地鼠血清均未检出HV抗体。结论福建省HFRS的疫源地以家鼠型疫区为主,降低家鼠尤其是褐家鼠密度,可控制本病在福建的扩大流行。     

从野鼠型疫区家犬血清中检出EHFV家鼠型抗体

<正> 近年来,由于病原学和血清学的突破性进展,我国已报道的流行性出血热(EHF)宿主动物有50多种。米尔英等从家鼠型疫区6种家畜家禽血清中检出EHF 病毒抗体,张云等从野鼠型疫区狗肺中检出EHF 病毒抗原并分离出两株病毒。但从野鼠型疫区犬血清中检出 EHF 病毒家鼠型抗体,未见报道。 四川省雅安市是以黑线姬鼠为主要传染源的     

酶斑点杂交法与双抗体夹心法检测汉坦病毒感染的比较

目的将酶标抗汉坦病毒NP抗原单链抗体应用于酶斑点杂交法和双抗体夹心法,检测汉坦病毒感染,探索价格低廉早期HFRS诊断试剂。方法以戊二醛偶联辣根过氧化物酶和抗汉坦病毒NP抗原单链抗体,制备酶标单链抗体,并应用于酶斑点杂交法和双抗体夹心法中,检测56份早期HFRS患者血清及66份阴性对照血清。结果56份HFRS患者血清中,双抗体夹心法检测出29例阳性,阳性率为51.79%,酶斑点杂交法检测出28例阳性,阳性率为50.00%,两方法检测66例阴性对照血清,结果均为阴性。统计学处理,两方法差异不显著。结论以酶标抗汉坦病毒NP抗原单链抗体制备的酶斑点杂交和双抗体夹心诊断试剂,均为稳定性好、假阳性率低、造价低廉、诊断可靠的诊断试剂。     

2013年云南省肾综合征出血热监测分析

目的监测2013年云南省肾综合征出血热(HFRS)人间疫情和宿主动物,分析流行病学特点,为制定防治策略提供科学依据。方法居民区用鼠笼法、野外用鼠夹法,进行鼠密度监测,采集人血清以及宿主动物肺脏组织,用免疫荧光法进行汉坦病毒(HV)抗原或抗体检查,采用Spss 17.0软件分析数据。结果 2013年云南省共报告HFRS病例95例,其中实验室诊断81例,临床诊断14例,发病率0.20/10万;发病季节以5月和12月为主,发病人群以中老年男性农民为主;泸西县、祥云县和大姚县3个监测点秋季人群HV阳性率分别为14.15%、16.00%和3.00%,差异有统计学意义(χ2=8.37,P0.05);3个监测点共捕获12种424只小兽,其中居民区褐家鼠为优势鼠种,野外大绒鼠和高山姬鼠为优势鼠种,宿主动物HV阳性率为13.21%(56/424),阳性宿主动物为褐家鼠、黄胸鼠、大绒鼠、高山姬鼠、中华姬鼠、锡金小鼠、短尾鼩和灰麝鼩。结论滇西地区为HFRS主要发病地区,秋季居民区HFRS的防控更为重要,监测点广泛存在以褐家鼠为主要传染源的家鼠型HFRS疫源地,还存在以高山姬鼠和中华姬鼠为主要传染源的野鼠型HFRS疫源地,食虫动物短尾鼩和灰麝鼩也发现HV感染。     

地方株肾综合征出血热病毒生物学特性研究

肾综合征出血热(HFRS)分为4个血清型,目前国内已证实存在Hantaan型(HTN),Seoul(SEO)2个血清型.根据单克隆抗体的抗原分析认为,出血热病毒有复杂的抗原决定簇,毒株间存在明显的抗原差异.我们选择肾综合征出血热疫区抗原阳性鼠肺组织,现症病人外周静脉血及尿液,分离出11株出血热病毒.用McAb对其抗原性进行分析,同时测定毒株毒力.     

一起实验动物型肾综合征出血热流行的调查研究

目的对实验动物型肾综合征出血热疫情进行流行病学调查和病毒学研究,掌握流行特点、疫源范围并控制疫情。方法收集相关流行病学资料,采集大白鼠血清、肺脏组织和接触人群血清标本,用反向被动血凝抑制(RPH I)和间接免疫荧光试验(IFA)检测汉坦病毒抗体或抗原,用RT-PCR法对阳性鼠肺进行汉坦病毒分型。结果2003年5~6月,云南省3个单位的实验动物大白鼠群中发生汉坦病毒流行并导致1人发病,接触人群的平均隐性感染率为20%(15/75);用RPH I和IFA法检测大白鼠血清,汉坦病毒总抗体和IgG抗体阳性率分别为45.99%(63/137)和37.27%(41/110),抗体滴度在1∶20~1∶1 280之间,两种方法检测结果无显著性差异(χ2=1.33,P>0.05);两个疫点单位的大白鼠肺脏组织中汉坦病毒抗原阳性率分别为56.25%(9/16)和35.00%(7/20);用RT-PCR对病毒抗原阳性的大白鼠肺组织进行汉坦病毒分型,证实为汉城型病毒感染。对调查确定的疫点鼠群及饲养场所进行了疫源处理,彻底消灭了传染源,扑灭了疫情。结论本次实验动物型肾综合征出血热流行属汉城型汉坦病毒引起,主要发生在W istar大白鼠鼠群。大白鼠对汉坦病毒高度易感,具有较高的感染率并能产生高滴度的抗体。     

肾综合征出血热病毒结构蛋白在患者尿中融合细胞上的表达与肾脏损害

本文对43例肾综合征出血热(HFRS)患者尿液脱落细胞进行观察,有融合细胞(FC)者27例,阳性率为63%(27/43)。凡FC阳性者尿蛋白均呈阳性。用McAb免疫酶技术检测,所有FC上均发现特异性HFRS抗原。经用A_(35)、3D_8(抗结构蛋白单克隆抗体)分别对8例FC标本进行分析,发现A_(35)阳性2例、3D_8阳性7例,抗原表达以FC膜处更为明显。本结果表明,泌尿系统上皮细胞FC的形成与HFRS膜蛋白在上皮细胞膜上的表达有关。     

ELISA法、免疫印迹法与对流免疫电泳法检测抗ENA抗体的比较

目的分析比较目前常用的几种检测抗ＥＮＡ抗体方法的敏感性和特异性。方法用免疫印迹法（ＩＢＴ）、酶免法（ＥＬＩＳＡ）及对流免疫电泳法（ＣＩＥ）检测１３０例各种结缔组织病、非结缔组织病人及健康人血清中的抗ＥＮＡ抗体。结果２０例健康人的血清三种方法检测均为阴性;８０例结缔组织病患者,检测抗Ｓｍ抗体、抗ＲＮＰ抗体,ＩＢＴ法、ＥＬＩＳＡ法均较ＣＩＥ法敏感（Ｐ＜００５）。检测抗ＳＳＢ抗体,ＥＬＩＳＡ法较ＣＩＥ法、ＩＢＴ法敏感（Ｐ＜００５）。抗ＳＳＡ抗体的检测,ＩＢＴ法由于采用兔胸腺丙酮粉为抗原,ＳＳＡ抗原成分有缺失,造成检出率低。ＩＢＴ法与ＥＬＩＳＡ法检测的符合率较高。结论ＩＢＴ法、ＥＬＩＳＡ法检测抗Ｓｍ抗体、抗ＲＮＰ抗体时,敏感性优于ＣＩＥ法。ＣＩＥ法、ＥＬＩＳＡ法检测抗ＳＳＡ抗体优于ＩＢＴ法。ＥＬＩＳＡ法检测抗ＳＳＢ抗体敏感性较高。上述三种方法在临床抗ＥＮＡ抗体的检测中可互相验证和补充。     

New serologic tests for early detection of coccidioidomycosis

Arizona college students suspected of having recently acquired coccidioidomycosis were tested for anticoccidioidal antibodies and circulating fungal antigens using conventional antibody detection methods and new ELISA procedures. Of 233 patients with compatible symptoms, 26 had anticoccidioidal antibodies detected by conventional tests. ELISA detected antibodies in sera from 20 of these patients and also from another 25 patients. Patients with antibodies detected by either conventional or ELISA procedures were significantly more likely to have abnormal chest radiographs, elevated erythrocyte sedimentation rates, or absent upper respiratory symptoms than were other patients. Circulating antigen was found in sera from 35 patients, 33 of whom had no detectable anticoccidioidal antibodies at that time. Detectable antigen was noted frequently in sera obtained within the first month after the onset of symptoms and was infrequently detected later when more patients exhibited antibodies. These results indicate the feasibility of developing ELISA procedures using spherule-derived antigens for earlier detection of coccidioidal infections.     

Detection of Leptospira-Specific Antibodies Using a Recombinant Antigen-Based Enzyme-Linked Immunosorbent Assay

We produced three highly purified recombinant antigens rLipL32, rLipL41, and rLigA-Rep (leptospiral immunoglobulin-like A repeat region) for the detection of Leptospira-specific antibodies in an enzyme-linked immunosorbent assay (ELISA). The performance of these recombinant antigens was evaluated using 121 human sera. Among them, 63 sera were microscopic agglutination test (MAT)-confirmed positive sera from febrile patients in Peru, 22 sera were indigenous MAT-negative febrile patient sera, and 36 sera were from patients with other febrile diseases from Southeast Asia, where leptospirosis is also endemic. Combining the results of immunoglobulin M (IgM) and IgG detection from these three antigens, the overall sensitivity is close to 90% based on the MAT. These results suggest that an ELISA using multiple recombinant antigens may be used as an alternative method for the detection of Leptospira-specific antibodies.     

Serological prevalence of anti-latex IgE antibodies in unselected blood donors in Argentina.

The prevalence of specific IgE to natural rubber latex proteins in the general population remains uncertain. The purpose of this study was to determine the prevalence of sera containing specific IgE antibodies to latex proteins using immunoenzymatic methods. A population of 500 unselected adult voluntary blood donors was the source of the sera used in this study. Two different immunoenzymatic methods (EAST and CARLA) were used to analyze the presence of specific IgE antibodies. Confirmation assay was carried out by inhibition ELISA and immunoblotting. Sera from healthy nonatopic individuals were also used as control. Two hundred and twenty five sera showed higher than normal total IgE levels. Of those, three presented latex specific IgE antibodies, which could be inhibited in a dose-response manner with the natural rubber latex and glove extracts. Several latex allergens were recognized by the IgE antibodies from these positive sera. This low seroprevalence (0.66%) indicates that latex hypersensitivity is not an important problem in the general population. We believe that prevention of latex exposure is only necessary in high risk groups of patients.     

Detection of antibodies to Epstein-Barr virus antigens by enzyme-linked immunosorbent assay

An enzyme-linked immunosorbent assay (ELISA) is described for the serologic analysis of antibodies to Epstein-Barr virus (EBV)-associated nuclear antigen (EBNA), viral capsid antigen (VCA), and early antigen (EA). The specificity of each of the ELISAs was demonstrated by the use of well-characterized human sera shown by immunofluorescence assay to be variously reactive for antibodies to one or more of the three viral antigens studied. The ELISA for EBNA was four to 256 times more sensitive than immunofluorescence assays with all 33 EBNA-positive sera tested. The ELISAs for VCA and EA were also more sensitive than immunofluorescence assays: approximately 50% of the sera tested showed higher antibody titers. Sera that were negative for all three antigens by immunofluorescence assay were also negative by ELISA for each antigen. These ELISAs for EBV are rapid, sensitive, and objective and thus provide new and valuable methods for the detection of antibodies to EBV-related antigens.     

ELISA检测华支睾吸虫病患者血清特异性IgG_4的诊断价值

目的　探讨用ELISA检测华支睾吸虫病患者血清中特异性IgG4 的诊断价值。　方法　用华支睾吸虫成虫可溶性抗原进行ELISA分别检测华支睾吸虫病患者 (76例 )血清中的特异性IgG和IgG4 抗体及日本血吸虫病、并殖吸虫病、囊尾蚴病患者 (分别为 63、3 5、41例 )和健康者 (65人 )血清中的交叉抗体。　结果　检测 76例华支睾吸虫病患者血清中IgG4 的检出率为 93 .42 % ,检测 65例健康者血清中的IgG4 均为阴性 ,分别与检测IgG结果比较差异均无显著性意义 (P均 >0 .0 5 ) ;与其它寄生虫病的交叉反应率 ,IgG4 显著低于IgG ;诊断效率及阳性、阴性预告值分别为 96.45 %、10 0 %和 92 .85 %。　结论　用ELISA检测华支睾吸虫病患者血清中特异性IgG4 具有较高的诊断应用价值。     

Use of synthetic peptides in the study of the antibody response to Plasmodium vivax sporozoites.

Synthetic peptides reproducing 4 DRADGQPAG (D4) and a sequential array of DRADGQPAG and DRAAGQPAG repeats (DDAAD) of the Plasmodium vivax circumsporozoite (CS) protein were investigated for their potential use in the detection of P. vivax sporozoite antibodies in human sera. These peptides specifically inhibited the binding of monoclonal antibodies to the P. vivax CS protein in Western blots. However, when D4 and DDAAD peptides were used in an enzyme-linked immunosorbent assay (ELISA) for the detection of human antibodies, more sera bound to the DDAAD (61%) than to the D4 peptide (22%). This binding was specific, and suggested that the DDAAD peptide contained epitopes constituted by the sequential array of DRADGQPAG and DRAAGQPAG repeat variants and absent in the D4 peptide. The ELISA using the DDAAD peptide was applied to the detection of P. vivax CS protein antibodies in a large number of sera from Kataragama, an endemic area in Sri Lanka. The prevalence of these antibodies increased with age, reaching 40% in adults greater than 50 years old. The ELISA employing the DDAAD peptide represents a simple and useful tool for the analysis of the antibody response to P. vivax sporozoites in naturally exposed individuals.     

Comparison of cell-ELISA, flow cytometry and Western blotting for the detection of antiendothelial cell antibodies

OBJECTIVE: There is still great uncertainty in the detection of antiendothelial cell antibodies (AECA). The aim of our study was to compare the results obtained using different methods. METHODS: Sera were obtained from 71 patients with a variety of vasculitides. Three assay methods were used: cell ELISA, flow cytometry (FACS) and Western blot (WB). RESULTS: In the ELISA 12/17 patients with systemic lupus erythematosus (SLE), 1/12 with Churg Strauss (CS) disease, 3/12 with micropolyarteritis (MPA) and 5/30 with Wegener's granulomatosis (WG) tested positive. Most of the sera that were positive on ELISA were not by FACS. Among the negative sera, 50% of WG, 40% of MPA, 20% of CS and 40% of SLE became positive on WB. There were some specific patterns of reactivity for a given disease, so that some bands could be assigned to a disease. CONCLUSION: The discrepancies in the results may most probably be accounted for by differences between the antigenic preparations. Caution must thus be exercised when interpreting the results of any of these three tests.     

Evaluation of a Malaria Antibody ELISA and Its Value in Reducing Potential Wastage of Red Cell Donations from Blood Donors Exposed to Malaria, with a Note on a Case of Transfusion-Transmitted Malaria

Background and objectives: Blood donations are often wasted for lack of a satisfactory procedure to evaluate donors potentially exposed to malaria. Materials and methods: We evaluated a commercial ELISA for the detection of antibodies to malaria and compared it with an immunofluorescent antibody test (IFAT). Results: When 5,311 sera from routine non-exposed donors were tested, 24 (0.45%) were positive by the ELISA, using a Plasmodium falciparum antigen. Seventeen were subjected to confirmatory testing but none were positive by IFAT. Of 1,000 donors potentially exposed in endemic areas 15 (1.5%) were repeatably reactive by ELISA. 10 of these were tested by IFAT and 2 were positive. When 150 patients attending the Hospital for Tropical Diseases in London with acute malaria were tested, 73% of those infected with P. falciparum were repeatably reactive for malarial antibodies by ELISA and 56% with Plasmodium vivax. Of 88 stored clinical sera tested by both IFAT and ELISA 56 were positive by IFAT and of these 52 (93°/0) were positive by ELISA. Conclusion: The ELISA is sufficiently sensitive and specific to screen at-risk donors. Its use could safely retrieve 40,000 red cell units currently discarded each year in Great Britain.     

Comparative analysis of gp41 antigens by enzyme-linked immunosorbent assays for detecting antibodies to human immunodeficiency virus type 1

We have compared the antigenic qualities of human immunodeficiency virus type 1 (HIV-1) gp41 glycoprotein with a synthetic oligopeptide (peptide R21S) and a bacterially synthesized protein (protein 566), which are homologous with the N-terminal region of gp41, in enzyme-linked immunosorbent assays (ELISA) for detecting antibodies to HIV-1 in sera of patients with the acquired immunodeficiency syndrome (AIDS) or the aids-related complex (ARC). Although the use of all three types of antigens readily allowed the detection of antibodies in human sera, ELISA employing purified gp41 glycoprotein and the protein 566 were more specific and sensitive than the peptide R21S ELISA.