SLE患者血清抗磷脂抗体的分布及临床意义

目的:探讨抗磷脂抗体(APA)在SLE患者血清中的分布及临床意义。方法:应用酶联免疫吸附实验(ELISA)法检测64例正常人和56例SLE患者血清中6种APA。结果:SLE患者IgG型抗心磷脂抗体(aCL)、抗磷脂酰肌醇抗体(aPI)、抗磷脂酸抗体(aPA)、抗磷脂酰丝氨酸抗体(aPS)、抗磷脂酰胆碱抗体(aPC)的A值和阳性率均显著高于正常人;IgM型aCL、aPA、aPE、aPS、aPC的A值和阳性率均显著高于正常人。SLE时IgG型和IgM型APA的总阳性率分别为67.86%和69.65%。结论:正常人血清中存在低滴度的APA,SLE患者血清中APA的阳性率高于正常人。APA的检测对早期诊断SLE可能有一定意义。     

系统性红斑狼疮患者抗磷脂抗体的检测

目的探讨抗磷脂抗体(APA)在正常人的分布及其与系统性红斑狼疮(SLE)的关系。方法应用酶联免疫吸附实验(ELISA)检测82例正常人和32例SLE患者血中6种APA。结果正常人IgG型抗心磷脂抗体(aCL)、抗磷脂酰肌醇抗体(aPI)、抗磷脂酸抗体(aPA)、抗磷脂酰乙醇胺抗体(aPE)、抗磷脂酰丝氨酸抗体(aPS)和抗磷脂酰胆碱抗体(aPC)的阳性率分别为6.10%、6.10%、7.32%、7.32%、3.66%和3.66%,IgM型aCL、aPA、aPC、aPS、aPE和aPI的阳性率分别为2.44%、3.66%、3.66%、6.10%、6.10%和4.88%。SLE患者IgG型aCL、aPA、aPS、aPC、aPI的A值和阳性率显著高于正常人,IgM型aCL、aPA、aPS、aPE、aPC的A值和阳性率显著高于正常人;SLE时IgG和IgM型APA的总阳性率分别为68.75%和71.88%。结论在正常人中存在滴度较低的APA;这些APA互相间有一定的关系,多同时出现。SLE时进行APA检查,对抗磷脂综合征的诊断可能有一定的意义。     

梅毒、红斑狼疮和皮肌炎患者抗磷脂抗体检测

目的：探讨抗磷脂抗体与梅毒、系统性红斑狼疮(SLE)和皮肌炎(DM)的关系。方法：应用酶联免疫吸附试验检测16例梅毒患者、32例SLE患者和11例皮肌炎患者血清中的抗磷脂抗体。结果：①梅毒患者抗磷脂抗体的吸光度（A值)[lgG型抗磷脂酰胆碱抗体(aPC)除外]和IgM型阳性率[抗磷脂酸抗体(aPA)除外]与正常人相比显著升高，IgG型抗磷脂抗体阳性率只有抗心磷脂抗体(aCL)和抗磷脂酸抗体(aPA)，与正常人相比显著升高；②SLE患者抗磷脂抗体的A值和阳性率[IgG型抗磷脂酰乙醇胺抗体(aPE)和IgM型抗磷脂酰肌醇抗体(aPI)除外1与正常人相比显著升高；③DM患者抗磷脂抗体的A值[IgG型抗磷脂酰乙醇胺抗体(aPE)除外1与正常人相比显著升高。④梅毒和SLE患者总阳性率与正常人相比显著升高。结论：自身免疫性疾病患者的抗磷脂抗体与感染时有所不同；抗磷脂抗体虽然存在于多种自身免疫性疾病中，但以SLE的阳性率最高。     

白癜风患者血清中抗酪氨酸酶抗体及可溶性细胞问黏附分子1的检测

目的探讨白癜风患者血清中抗酪氨酸酶IgG、IgM抗体滴度和可溶性细胞间黏附分子1（sICAM-1）水平与疾病活动程度的关系和临床意义。方法抗酪氨酸酶IgG、IgM抗体和sICAM-1检测采用酶联免疫吸附试验（ELISA）方法。结果①白癜风患者血清中抗酪氨酸酶IgG抗体平均滴度为0．316，显著高于正常人对照组0．082（P〈0．001）；白癜风患者血清中抗酪氨酸酶IgM抗体平均滴度为0．238，显著高于正常人对照组0．065（P〈0．001），②白癜风患者进展期血清抗酪氨酸酶IgG、IgM抗体滴度明显高于稳定期（P均〈0．001），泛发型明显高于局限型（P均〈0．001）。③抗酪氨酸酶IgG、IgM抗体滴度与抗黑素细胞IgG抗体阳性及IgM抗体阳性均呈币相关（P均〈0．001）。④白癜风患者血清sICAM-1平均水平为697．40ng／mL，显著高于正常人对照组602．40ng／ml（P〈0．001）；进展期高于稳定期（P〈0．001）；泛发型高于局限型（P〈0．001）：稳定期和局限型白癜风患者血清中sICAM-1水平与正常人对照组差异无统计学意义（P均〉0．05）。结论白癜风患者血清中抗酪氨酸酶IgG、IgM抗体和sICAM-1与疾病活动性和严重程度相关。     

病毒性皮肤病

951983 单纯疱疹病毒2型血清IgG及IgM抗体的酶免疫检测/钱起丰…//中华皮肤科杂志。-1995,28(3).-185～186 为了解发病情况,采用德国Virotech公司生产的HSV-2 IgG及IgM抗体酶免疫试剂检测生殖器疱疹患者60例和40例正常人。结果HSV-2抗体总阳性率为88.3％(53/60),其中IgG抗体阳性率为73.3％(44/60),IgM抗体阳性率为20.0％(12/60),其中有3例两者均为阳性。40例正常人分别为20％(8/40)及0,与患者组相比差异有显著性(P<0.01)。初发型与     

ELISA抗梅毒螺旋体抗原的特异性IgG/IgM抗体在诊断梅毒中的应用

目的探讨酶联免疫吸附测定(ELISA)抗梅毒螺旋体抗原的特异性IgG/IgM抗体在诊断梅毒中的应用。方法临床诊断或怀疑为梅毒的97例患者和74例非梅毒患者的血清同时接受ELISA抗梅毒螺旋体抗原的特异性IgG/IgM抗体和TPPA试验两种检测。结果ELISA抗梅毒螺旋体抗原的特异性IgG/IgM抗体具有较高的敏感性和特异性。结论ELISA抗梅毒螺旋体抗原的特异性IgG/IgM抗体适合于大样本的筛查和确诊。     

银屑病患者血清抗角蛋白抗体的免疫荧光研究

为了探讨血清抗角蛋白抗体与银屑病的关系以及该抗体的生理、病理意义,本文以正常人皮肤冰冻切片为抗原,用IIF检测了35例银屑病患者的血清,并与其它皮肤病和内科疾患作了对照观察.银屑病患者血清抗角蛋白抗体阳性率IgG11.76%,IgM54.29%,IgA54.29%,与正常人(IgG66,67%,IgM96.43%,IgA100%)相比,均明显降低.但23例其它皮肤病IgM60.85%,IgA43%和25例内科疾患IgM63.38%也明显低于正常人.结果提示,抗角蛋白抗体血清阳性率的降低,并非银屑病的特异表现,两者之间并无特殊联系.     

梅毒与系统性红斑狼疮患者抗心磷脂抗体的比较研究

目的 对梅毒和系统性红斑狼疮(SLE)患者血清中抗心磷脂(ACL)抗体的反应强度以及类型进行比较研究。方法 应用ELISA法对99例梅毒和75例SLE患者的血清中ACL抗体的反应强度以及ACL抗体的IgG与IgM类型进行检测。结果 SLE和梅毒患者血清中IgG型ACL抗体阳性率分别为48.00%和40.40%;梅毒的阳性血清反应强度高于SLE患者(P<0.001);IgM型ACL抗体的阳性率在SLE和梅毒患者中分别为18.67%和61.62%,梅毒的ACL抗体阳性率显著高于SLE患者(P<0.001),且梅毒患者IgM型ACL抗体阳性血清反应强度高于SLE患者(P<0.005)。结论 这种ACL抗体IgG、IgM阳性率与反应强度的差异,反映了SLE患者和梅毒患者产生ACL抗体的机理与功能有所不同。     

荧光定量PCR和酶联免疫吸附试验检测生殖器疱疹病毒感染的意义

目的:探讨荧光定量聚合酶反应(fluorescent quantitative PCR,FQ-PCR)和酶联免疫吸附法(ELISA)检测生殖器疱疹病毒感染的临床意义。方法:对性病门诊140例有现症生殖器疱疹(GH)患者用FQ-PCR检测生殖器疱疹病毒II型(HSV-2)和ELISA方法进行HSV-2抗原和抗体(包括IgG和IgM)检测。结果:FQ-PCR和HSV-2抗原法检测140例GH患者的阳性率分别为92.14%和89.29%,均明显高于HSV-2 IgG(66.43%)和IgM(14.29%)(P<0.01);125例具有典型临床症状如水疱、溃疡和宫颈糜烂等患者中:FQ-PCR和HSV-2抗原分别为100%和97.60%,均明显高于HSV-2IgG(65.60%)和HSV-2 IgM(14.40%)(P<0.01);15例表现为结痂的患者中:FQ-PCR、HSV-2抗原和HSV-2 IgM阳性率分别为26.67%、20.0%和13.33%,均明显低于HSV-2 IgG阳性率(P<0.01)。结论:FQ-PCR法和ELISA HSV-2抗原法均能快速准确检测GH感染;ELISA HSV-2 IgM抗体诊断GH感染的价值不大;ELISA HSV-2 IgG法对诊断临床症状不典型的GH有较大的价值。     

33例银屑病病人6种抗磷脂抗体的检测

目的：探讨抗磷脂抗体(APA)与银屑病的关系。方法：应用酶联免疫吸附试验(ELISA)检测33例银屑病和16例梅毒病人血中6种APA。结果：①银屑病病人IgG型aCL、aPA、aPS、aPC和aPI的A值和aPI的阳性率较正常人显著升高；IgM型APA的A值较正常人显著降低，均阴性；②梅毒病人IgG型aCL、aPA、aPE和aPI的A值和aCL、aPA的阳性率较正常人显著升高；IgM型aCL、aPS、aPE和aPC的A值和aCL、aPS、aPE、aPC和aPI的阳性率较正常人显著升高。结论：在银屑病时存在APA的机制与梅毒不同。     

Comparison of four different serological methods for detection of antibodies to Borrelia burgdorferi in erythema migrans.

Three different enzyme-linked immunosorbent assays (ELISA) and Western blot were compared in regard to the detection of antibodies to Borrelia burgdorferi in sera from 100 patients with erythema migrans and from 100 controls. For IgG detection, a commercial indirect ELISA kit with flagellum antigen (flagellum ELISA) was significantly more sensitive than the routinely-used indirect ELISA with sonicated whole-cell antigen (sonicate ELISA) (p = 0.008). The difference in positivity in the IgM test was of borderline significance (p = 0.058). An IgM antibody-capture ELISA with sonicated whole-cell antigen (capture ELISA) was significantly more sensitive than either the IgM sonicate ELISA (p less than 0.001) or IgM flagellum ELISA (p less than 0.001). With the Western blot pattern chosen as the criterion for positivity, IgM Western blot was at least equal to IgM capture ELISA in terms of the number of positive erythema migrans sera, but a frequent discrepancy between these two tests was noted as to positivity in individual sera. IgG Western blot was considered to be of less value for the diagnosis of current disease due to a high occurrence of positivity among controls.     

自身免疫性大疱性皮肤病患者血清中IgM抗体所识别的皮肤抗原的研究

目的:研究自身免疫性大疱性皮肤病患者血清中IgM抗体所识别的皮肤抗原成分.方法:该研究共纳入10例大疱性类天疱疮患者、15例天疱疮患者(包括7例红斑/落叶型和8例寻常型).首先通过直接免疫荧光法分析受试患者皮肤中所沉积的免疫球蛋白或补体,再通过免疫印迹方法分析患者血清中的IgM抗体所识别的皮肤抗原成分.结果:在10例大疱性类天疱疮患者的皮肤中,C3、IgG、IgM单独沉积的例数分别是4例、2例、1例,IgG和C3共同沉积的2例,IgG、C3和IgA三者共同沉积的1例;在15例天疱疮患者中,C3、IgG单独沉积的例数分别是4例和2例,IgG和C3共同沉积的6例,IgM和C3共同沉积的3例.免疫印迹研究发现9例(9/10)大疱性类天疱疮患者、11例(11/15)天疱疮患者血清中的IgM抗体可以识别皮肤中分子量约80 kD的蛋白质.结论:IgM在自身免疫性大疱性皮肤病患者的皮肤中沉积的几率很低,但大多数患者血清中的IgM抗体都能够识别分子量约80 kD的皮肤抗原.     

Antibody reactivity to Borrelia burgdorferi sensu stricto antigens in patients from the Brazilian Amazon region with skin diseases not related to Lyme disease

In the present study, we report the occurrence of borreliosis in patients from the Brazilian Amazonic region. Nineteen (7.2%) out of 270 dermatological patients with different skin diseases (no one with clinical Lyme disease), tested positive by ELISA for Borrelia burgdorferi. Serum samples from 15 out of the 19 ELISA‐positive patients were further evaluated by Western blot. Presence of Borrelia burgdorferi specific IgG was confirmed in eight (53.3%) out of the 15 patients. All eight patients with ELISA and Western blot positive reactions were treated with doxycycline, according to the Centers for Disease Control and Prevention guidelines. One of them had clinical manifestations of colagenosis and was sent to the Department of Internal Medicine for further investigation. Data presented here suggested that borreliosis “lato sensu” is in the Brazilian Amazon region.     

Evaluation of the fluorescent treponemal antibody-absorption (FTA-Abs) test specificity.

Serum samples from 43 patients with positive test for syphilis only in the FTA-Abs test, were evaluated. Three had primary or treated syphilis. Twenty-one (49%) had clinical and/or serological signs of Lyme borreliosis as assessed by whole-cell sonicate Borrelia burgdorferi ELISA and Western blot techniques. Seven (16%) had genital Herpes simplex infection and the remaining 12 patients, miscellaneous disorders. In control sera from 30 patients with Lyme borreliosis an isolated positive FTA-Abs reaction was found in 13 patients (43%). Elevated Borrelia ELISA titres were found in nine of 30 (30%) syphilitic patient serum samples, whereas Western blots for Borrelia were negative. Six per cent of healthy blood donors were seropositive for Borrelia. Lyme borreliosis is an important cause of cross-reactions in the FTA-Abs test. Other serological tests for syphilis and Western blot for Borrelia are useful for discrimination.     

Long-term serological follow-up of patients treated for chronic cutaneous borreliosis or culture-positive erythema migrans

The kinetics of antibodies to Borrelia burgdorferi following successful treatment of early and late cutaneous borreliosis were analysed in consecutive serum samples by an enzyme-linked immunosorbent assay (ELISA) technique. Twenty-three patients with culture positive erythema migrans were followed for 23+/-14 months: 41% stayed seronegative, 35% showed an isolated immunoglobulin M (IgM) response, 8% an isolated IgG response and 16% a combined IgM and IgG responses. In general, antibody levels peaked within the first 3 months of symptom onset, whereafter a gradual decline was observed within 1 year. Twenty-two patients with chronic cutaneous borreliosis were followed for 23+/-11 months and all patients stayed IgG positive. Nearly three-quarters showed a clear decline in IgG levels over the years, while the rest did not. After 9+/-1 years 88% of 16 patients examined were still IgG positive. In conclusion, treatment of erythema migrans should be initiated on clinical appearance as a substantial number of patients stayed seronegative. Treatment success may in part be monitored serologically for both seropositive erythema migrans and chronic cutaneous borreliosis as most patients show declining titres after successful treatment. However, continuously high titres do not necessarily indicate treatment failure.     

Granulomatous cheilitis and Borrelia burgdorferi: polymerase chain reaction and serologic studies in a retrospective case series of 12 patients

BACKGROUND: Granulomatous cheilitis (GC) is a chronic granulomatous inflammation of the lips of unknown etiology, which may be associated with peripheral facial nerve paralysis and/or lingua plicata (Melkersson-Rosenthal syndrome [MRS]). Borrelia burgdorferi is a spirochete that causes Lyme borreliosis, a multisystemic infectious disease with frequent occurrence of facial nerve paralysis. An etiologic role of B burgdorferi in various granulomatous diseases has been suggested. The present study was performed to examine a possible causative role of B burgdorferi for GC/MRS by B burgdorferi-specific polymerase chain reaction analysis of biopsy specimens from affected lip tissue and determination of B burgdorferi IgG and IgM serum antibodies using enzyme-linked immunosorbent assay and immunoblot tests. OBSERVATIONS: We examined a retrospective case series of 12 patients with GC/MRS from a Lyme borreliosis endemic area (median duration of disease, 8 months [range, 3-348 months]). Borrelia burgdorferi-specific DNA could not be amplified by polymerase chain reaction in any of the 12 patients. One (13%) of 8 patients tested had a serum B burgdorferi IgG response on enzyme-linked immunosorbent assay, and 2 patients (25%) had an IgM response, but immunoblot testing yielded negative results in all 8 patients. CONCLUSION: The results of the present study do not indicate that B burgdorferi has an etiologic role in GC/MRS.     

Borrelia burgdorferi and different types of morphea

Thirty patients with different clinical manifestations of morphea (circumscribed scleroderma) were investigated for serum antibodies against Borrelia burgdorferi determined by ELISA and Western blot analysis. Forty-six percent of the patients were seropositive. Western blots confirmed the ELISA results in 10 of 25 patients (40%), showing a reactivity pattern which can be seen in the course of Lyme borreliosis. In some cases the outcome after antibiotic treatment suggests a direct correlation between the further development of skin lesions and Borrelia infection. Because of these findings we suggest some morphea types to be possibly due to a B. burgdorferi infection.     

评价在辅助生育中检测单纯疱疹病毒2抗体对诊断生殖器疱疹的意义

【摘要】 目的 在分析生殖器疱疹患者单纯疱疹病毒（HSV）流行株的基础上,探讨HSV-2 IgM抗体、型特异HSV-2 IgG抗体的敏感性、特异性、阴性预测值和阳性预测值,评价辅助生育中二种抗体检测在诊断生殖器疱疹上的意义。 方法 对2009—2011年中山大学附属第一医院皮肤科193例生殖器疱疹患者临床分离病毒株培养并鉴定分型,了解主要的流行病毒型。生殖中心术前筛查HSV-2 IgM和（或）IgG阳性、疑诊生殖器疱疹的女性,丈夫同时抽血检查,共57对为临床观察组;选取HSV培养阳性生殖器疱疹患者68例作为阳性对照组;8 ~ 10岁儿童120例为阴性对照组。血清标本采用酶联免疫吸附法（ELISA）检测HSV-1 IgM和HSV-2 IgM抗体及型特异HSV-1 IgG、HSV-2 IgG抗体,对结果进行比对分析。 结果 阳性对照组68例中,HSV-1 IgM 14例（20.59%）、HSV-2 IgM 9例（13.24%）、HSV-1 IgG 61例（89.71%）、HSV-2 IgG 62例（91.18%）阳性;阴性对照组120例,分别为26例（21.70%）、16例（13.30%）、49例（40.80%）和0例阳性;两组HSV-1 IgM及HSV-2 IgM阳性率差异均无统计学意义（P > 0.05）,但HSV-1 IgG及HSV-2 IgG阳性率差异均有统计学意义（P < 0.01）。临床观察组57例女性中,HSV-1 IgM 46例（80.70%）、HSV-2 IgM 52例（91.23%）、HSV-1 IgG 48例（84.21%）、HSV-2 IgG 8例（14.04%）阳性;男性（配偶）分别为11例（19.30%）、5例（8.77%）、50例（87.71%）和7例（12.28%）阳性;两性的HSV-1 IgM及HSV-2 IgM阳性率差异均有统计学意义（P < 0.01）,而HSV-1 IgG及HSV-2 IgG阳性率差异均无统计学意义（P > 0.05）。HSV-2 IgM诊断生殖器疱疹的敏感性为13.24%,特异性为86.67%,阳性预测值36.00%,阴性预测值63.80%;HSV-2 IgG诊断生殖器疱疹的敏感性91.18%,特异性100.00%,阳性预测值100.00%,阴性预测值95.24%。 结论 该地区生殖器疱疹主要流行病毒型为HSV-2,仅5.18%是HSV-1。HSV-2 IgM诊断生殖器疱疹的敏感性、阳性预测值以及特异性、阴性预测值均低于HSV-2 IgG;辅助生育中型特异性HSV-2 IgG检测在诊断生殖器疱疹上的意义大于HSV-2 IgM。 【关键词】 疱疹,生殖器; 单纯疱疹病毒属; 免疫球蛋白G; 免疫球蛋白M     

四种商品化单纯疱疹病毒2型特异性IgG抗体检测试剂盒的比较

目的 比较4种商品化单纯疱疹病毒(HSV2)型特异IgG抗体检测试剂盒。方法 125份血清分别取自生殖器溃疡患者及无性传播疾病史的正常人。选择4种商品化HSV2型特异性IgG抗体检测试剂盒。ELISA方法严格按照试剂盒说明进行。结果 以蛋白印迹方法的结果为金标准,国产1、国产2、进口1和进口2共4种试剂盒敏感性和特异性分别为13.1%和98.4%,7.5%和100%,100%和11.1%,87.7%和96.7%;国产1、进口1和进口2三个试剂盒的ROC曲线下面积分别为0.885(0.822～0.948),0.852(0.747～0.902),0.947(0.950～0.998)。结论 进口2试剂盒结果与蛋白印迹结果的一致性最好,而其它3种试剂盒则与蛋白印迹结果的一致性很差。本实验结果表明在选择这类产品之前有必要重新评估其可靠性。     

Mini erythema migrans--a sign of early Lyme borreliosis

BACKGROUND: An erythema migrans (EM) remaining smaller than 5 cm in diameter, called mini EM by us, has not been addressed in detail. OBJECTIVE: To study the significance of the mini EM as a sign of Lyme borreliosis. METHODS: Patients with suspected mini EM were retrospectively selected out of 257 consecutive patients with EM. The diagnosis of mini EM rested on the cultivation of Borrelia burgdorferi. Species and subtype analysis of culture isolates was performed using outer surface protein A (OspA) polymerase chain reaction followed by restriction fragment length polymorphism and sequencing of the OspA gene. RESULTS: There was one patient with definite (0.4%) and another patient with a questionable mini EM. Borrelia garinii OspA type 6 was identified in the patient with the definite and B. burgdorferi sensu lato in the patient with the questionable mini EM. CONCLUSION: The mini EM represents an important and apparently uncommon sign of early Lyme borreliosis.