乙酰螺旋霉素联合阿奇霉素治疗孕期弓形虫感染的临床效果

目的 目的 探讨螺旋霉素联合阿奇霉素治疗孕期弓形虫感染的综合治疗方法。方法 方法 应用ELISA方法检测孕妇血清 特异性弓形虫IgG和IgM抗体, 并采用PCR方法检测羊水中弓形虫感染情况; 选取其中3例弓形虫IgM抗体阳性孕妇作为 治疗对象, 应用螺旋霉素联合阿奇霉素进行综合治疗, 通过血清学特异性抗体检测和PCR检测结果初步判断其疗效。结 结 果 果 经ELISA检测, 孕期妇女血清特异性弓形虫IgG和IgM抗体的阳性率分别为5.97% （17/285） 和1.05% （3/285）, 对3例血 清IgM抗体阳性孕妇的羊水进行PCR检测特异性弓形虫基因, 有2例呈阳性。经过2种药物的联合治疗, 这2例孕妇血清 特异性弓形虫IgM抗体滴度阴转, PCR检测产妇脐带血中弓形虫基因为阴性。结论 结论 螺旋霉素联合阿奇霉素治疗孕期弓 形虫感染安全、 有效。     

儿童先天性病残与弓形虫感染关系的研究

目的　探讨儿童先天性病残与弓形虫感染的关系。方法　应用间接血凝试验 (IHA)和膜抗原酶联免疫吸附试验 (EL ISA)检测 2 97例先天性病残儿童血清弓形虫抗体。结果　 2 97例先天性病残儿童弓形虫抗体阳性率 2 1.2 1% (6 3/ 2 97) ,显著高于后天获得性病残儿童弓形虫抗体阳性率15 .2 5 % (45 / 2 95 ) (χ2 =3.5 2 ,P<0 .0 5 )及同期健康儿童弓形虫抗体阳性率 6 .76 % (10 / 14 8) (χ2 =15 .0 5 ,P<0 .0 1)。先天性病残儿童父、母弓形虫抗体阳性率 (父 2 1.5 5 %、母 2 9.97% )与同期健康儿童父、母弓形虫抗体阳性率 (父 4 .0 5 %、母 5 .4 0 % )相比较 ,差异有显著性 (父 -父 χ2 =2 2 .81、OR=6 .5 0、P<0 .0 1,母 -母 χ2 =34.96 ,OR=7.4 9、P<0 .0 1)。与后天获得性病残儿童父、母弓形虫抗体阳性率 (父 15 .5 9%、母 2 1.6 9% )比较 ,差异均具有显著性 (父 -父 χ2 =3.4 7,P<0 .0 5 ,母 -母 χ2 =5 .2 8,P<0 .0 1)。10 8例弓形虫抗体阳性的儿童病残家庭 ,父或母至少有一方弓形虫抗体呈阳性的家庭有 5 6户 ,占阳性病残儿家庭的 5 1.85 %。提示弓形虫感染与优生优育关系密切。结论　弓形虫感染是儿童先天性病残的重要致残因素之一 ,对优生优育夫妇积极开展弓形虫感染的血清学监测 ,将对提高人口素质 ,     

河南省部分地区猪弓形虫感染调查及猪源虫株对小鼠的接种试验

目的了解河南省部分地区猪弓形虫感染情况和了解猪源弓形虫在小鼠体内产生与致病情况。方法IHA法、姬姆萨染色法和ELISA方法。结果在检查的2325份猪血清中,IHA方法查出304份为阳性,阳性率为13.1%;IHA抗体阳性血清抗体样品再以ELISA法检测循环抗原,查出23份为阳性;采集的脏器病料应用姬姆萨染色法检查滋养体,在3个猪群中镜检查到弓形虫滋养体。猪源虫株感染小鼠,第二代感染后第5天检测到IHA抗体,同时可在小鼠腹水内查到滋养体。结论河南省周口等7个地区猪弓形虫感染颇严重;猪源虫株接种小鼠试验可获成功。     

淮南地区孕妇弓形虫感染血清学分析

目的探索淮南地区孕妇弓形虫感染情况。方法运用酶联免疫吸附法(ELISA)检测228例孕妇(妊娠八周至七个月)静脉血中弓形虫(Toxoplasma godii,TO)抗体,即 Tox-IgG 抗体和 Tox-IgM 抗体。结果发现有猫犬接触史(指现在或曾经养过猫犬的)孕妇弓形虫感染率明显高于无猫犬接触史孕妇(P<0.01),两者有显著性差异;但城市与乡镇、适龄(≤35岁)与高龄(>35岁)孕妇弓形虫感染率无显著性差异(P>0.05);而首次妊娠孕妇与非首次妊娠孕妇弓形虫感染率有显著性差异(P<0.05)。结论有无描犬接触史是孕妇感染弓形虫的主要因素,二者相关性显著。     

先天性出生缺陷儿童弓形虫感染血清学调查

目的探讨儿童先天性出生缺陷与弓形虫感染的关系。方法应用弓形虫间接血球凝集试验(IHA)和弓形虫膜抗原酶联免疫吸附试验(ELISA)检测300例先天性出生缺陷儿童血清弓形虫抗体,并以35例因后天获得性外伤或车祸致残儿童作为对照。结果300例先天性出生缺陷儿童弓形虫抗体阳性66例,阳性率为22.00%;显著高于后天获得性外伤或车祸致残儿童的弓形虫抗体阳性率8.57%(χ2=3.54,P<0.05)。同时在66例弓形虫抗体阳性的先天性出生缺陷儿童家庭中,其父母至少有一方弓形虫抗体阳性的家庭达38户,占弓形虫抗体阳性的先天性出生缺陷儿童家庭的57.58%。结论弓形虫感染是儿童出生缺陷的重要因素之一,对优生优育夫妇积极开展弓形虫感染的血清学监测,将对提高人口素质、控制先天性弓形虫感染的发生具有重要意义。     

武汉地区人群弓形虫感染血清学调查分析

目的了解武汉市弓形虫感染现状,为制定防治策略提供科学依据。方法采用酶联免疫吸附试验(ELISA)方法,检测人群血清弓形虫IgG抗体。结果共检测3009人,阳性141人,平均阳性率4.69%。其中特殊人群(兽医、饲养员、肉贩、宠物猫犬主、孕妇、献血员等)阳性率6.51%(117/1798),一般人群(对照组)阳性率1.98%(24/1211),有非常显著意义差异(P<0.01)。不同地区、性别、民族以及文化程度之间差异无显著性意义(P>0.05)。结论弓形虫血清学阳性率与接触感染动物的机会密切相关,兽医、饲养员、肉贩等是弓形虫感染的高危人群;本次调查孕妇与献血员弓形虫阳性率高于一般人群,应引起重视,建议加强血清学监测,便于及时采取有效干预措施。     

弱智儿童弓形虫感染情况的分析

弓形虫能侵犯多种细胞,尤其是大脑和神经系统损害较大,以致造成胎儿神经系统发育障碍,乃至终身残疾或死亡。自1988～1990年3月对本校附属新华医院神经儿内科门诊或住院的2～12岁患儿共189例及其99例弱智儿童的母亲进行了弓形虫血清学的普查(IHA,IFA—IgG,IFA—IgM)。结果189例各种神经发育延缓或障碍的儿童,血清抗体阳性为46例(IHA滴度1:80～160),阳性率为24.3％,其中63例智力低下儿童弓形虫抗体阳性率为     

阜阳市HIV/AIDS患者弓形虫感染情况调查

目的 了解安徽省阜阳市 HIV / AIDS 患者弓形虫的感染情况,以及弓形虫合并感染对患者 CD4+ T 淋巴细胞计数的影响,为 HIV / AIDS 患者弓形虫病防控提供参考依据。 方法 以安徽省阜阳市 2020 年 1 月至 2021 年 3 月未经治疗新报告的 HIV / AIDS 患者为调查对象,用酶联免疫吸附试验(ELISA)检测其血清弓形虫 IgG 抗体,同时检测 CD4+T 淋巴细胞水平。 结果 共调查 HIV / AIDS 患者 449 例,其中,男性 348 例,女性 75 例,36 例性别不详;年龄以 20~ 60 岁为主。 检测出弓形虫 IgG 抗体阳性 5 例,阳性率为 1. 11%。 弓形虫 IgG 抗体阴性的 HIV / AIDS 患者CD4+T 淋巴细胞计数最低为 1 个 / μL,最高为 1 616 个 / μL,中位数(四分位间距)为 287(170,439)个 / μL;弓形虫IgG 抗体阳性的 HIV / AIDS 患者 CD4+T 淋巴细胞计数最低为 43 个 / μL,最高为 325 个 / μL,中位数(四分位间距)为 139(86,237)个 / μL,两者间差异无统计学意义(Z = -1. 749,P>0. 05 )。 结论 安徽省阜阳市 HIV / AIDS 患者弓形虫感染率较低,CD4+T 淋巴细胞水平与弓形虫感染之间的关系有待进一步研究。     

3种方法检测弓形虫IgG抗体的效能

目的 目的 比较3种不同的检验方法对弓形虫IgG抗体的检测效能, 并进行分析。方法 方法 采用临床上常用的金标法、 间接血凝试验 （IHA）、 酶联免疫吸附实验（ELISA）, 对304份血清标本进行弓形虫IgG抗体平行检测, 比较各检测方法的敏 感性、 特异性和Youden指数。结果 结果 金标法、 IHA、 ELISA这3种方法对弓形虫IgG抗体检测的敏感性分别为85.5%、 89.8% 和91.9%, 三者之间差异没有统计学意义 （χ2 = 4.12, P > 0.05）; 特异性分别是92.4%、 96.6%和97.5%, 差异亦无统计学意义 （χ2 =4.06, P > 0.05）。ELISA法的检测效率和Youden指数分别为94.1%和0.89, 高于IHA法和金标法。结论 结论 ELISA法检 测弓形虫IgG抗体的敏感性和特异性较高, 可自动化, 适合于大规模的弓形虫IgG抗体筛查。     

3种血清学方法检测新流行区血吸虫病人治疗前后抗体水平的变化

应用COPT、IHA、ELISA检测新流行区44例血吸虫病人吡喹酮治疗前后抗体水平变化。结果,治后6个月,COPT、IHA和ELISA的抗体阴转率分别为47.7％、9.1％和22.7％;环沉率均值由治前27.3％下降至9.9％,IHA和ELISA检测的抗体滴度均有明显下降,治后12个月COPT的阴转率较IHA、ELISA为高,但治后12～18个月3法检测的抗体水平未见继续下降。感染度较高(EPG≥16)的23例患者,治前3法阳性率均为95.7％,治后6月、12个月抗体水平下降幅度COPT明显高于IHA和ELISA。在新流行区COPT近期疗效考核的效果比IHA和ELISA为好。     

几种弓形虫IgM酶联免疫吸附试验的建立及评估

目的　建立和评估几种弓形虫ELISA -IgM的检测方法。 方法　应用酶联免疫吸附试验 (ELISA)的原理 ,建立四种检测方法 ,并进行比较。结果　检测 373例孕妇及正常献血员血清标本 ,方法Ⅰ、方法Ⅱ、方法Ⅲ、方法Ⅳ的阳性率分别为3 8%、3 2 %、2 9%、2 4 %。结论　利用抗人IgM、弓形虫抗原和抗体建立的捕获法具有快速、敏感、特异的特点 ,适合于育龄妇女的筛查和早期诊断。     

ELISA IFAT和PCR/生物素探针检测中枢神经系统疾病中弓形虫感染

目的　比较 ELISA、IFAT和 PCR/生物素探针检测弓形虫感染的效果 ,了解中枢神经系统疾病中弓形虫感染的情况。方法　应用 EL ISA、IFAT和 PCR/生物素探针 (PCR-BP)对 164例脑囊虫病、10 8例疑似脑囊虫病、88例原发性癫痫患者和 115例健康人群进行了血清弓形虫抗体及血液中弓形虫特异序列 DNA检测和比较。结果　 ELISA和 IFAT检测各组人群抗弓形虫抗体阳性率分别为 15 .85 %、14 .81%、13 .64 %和 6.0 9% ,14 .0 2 %、14 .81%、14 .77%和 6.0 9%。PCR-BP检测各组弓形虫特异性 DNA阳性率分别为 2 .44 % (4 /164 )、3 .70 % (4 /10 8)、3 .41% (3 /88)、0 (0 /115 )。结论　 PCR/生物素探针适合诊断现症弓形虫感染 ,而 EL ISA和 IFAT可作为弓形虫感染的筛选方法。脑囊虫病、疑似脑囊虫病和原发性癫痫患者中存在弓形虫感染     

弓形虫既往感染在孕期内对胎儿的影响

目的探讨既往感染者孕期内弓形虫的活动情况及对胎儿的影响。方法对68例抗弓形虫抗体IgG阳性、IgM阴性孕妇的血清、脐血采用酶联免疫吸附试验检测弓形虫抗体IgG、IgM、弓形虫循环抗原（CAg）,PCR法检测虫体DNA;胎盘样本采用直接涂片、匀浆涂片及PCR法观察弓形虫感染情况。结果68例弓形虫抗体IgG阳性孕妇中脐血弓形虫抗体IgG阳性28例,IgG胎盘垂直传播率41.2%;脐血弓形虫DNA阳性6例,宫内感染发生率8.8%;胎盘组织中虫体DNA阳性9例,宫内感染发生率13.2%。结论既往弓形虫感染孕期内仍可导致垂直传播。     

Toxoplasma pericarditis without immunosuppressant disorder detected by polymerase chain reaction of pericardial fluid: a case report

There have been several case reports, a total of 22 up to the present, of toxoplasma pericarditis. Out of them, in only a few cases the diagnosis was properly made with a proof of the microscopic presence of Toxoplasma gondii. This is the first report of toxoplasma pericarditis in which the presence of Toxoplasma gondii was detected by polymerase chain reaction of pericardial effusion. In addition, the previous reports will be reviewed, and compared to this present case. A 29-year-old woman, without immunosuppressant disorder, suffering from fever and orthopnea was admitted to our hospital. Blood chemistry findings indicated mild liver dysfunction and inflammation. Chest radiography showed cardiac enlargement. Electrocardiography showed sinus tachycardia and ST elevation. Echocardiography revealed a massive pericardial effusion. Pericardiocentesis demonstrated 638 ml of bloody fluid. Cytologic study of the fluid was class II for malignancy, and polymerase chain reaction to tuberculosis was negative. However, a high titer of the anti-toxoplasma antibody of 1: 20,480 (passive hemagglutination) indicated pericarditis caused by Toxoplasma gondii. Subsequently, Toxoplasma gondii was identified in the pericardial effusion by polymerase chain reaction. Clinical symptoms improved after pericardiocentesis, but 2 months later pericarditis recurred. Treatment was started with 800 mg acetylspiramycin daily but failed to improve the symptoms. Because of the development of pleuritis, treatment was changed to sulfadoxine 1,000 mg/pyrimethamine 50 mg. After the treatment with them, her symptoms improved. Only 22 cases of toxoplasma pericarditis have been reported worldwide and 15 of those cases were without immunosuppressant disorder. The usual symptoms at the onset of pericarditis without immunosuppressant disorder are fever, dyspnea and chest pain. Seven patients developed cardiac tamponade. Pericardiocentesis was performed in 8 cases and the pericardial fluid was hemorrhagic in 6. Pericardial thickening was detected in 5 cases. The diagnosis of toxoplasma infection is very difficult, because asymptomatic infection of Toxoplasma gondii is very common. Pericarditis is a disease difficult to confirm the etiology. Detection of Toxoplasma gondii in pericardial effusion by the polymerase chain reaction is very useful for its diagnosis.     

Seroepidemiological study of toxoplasmosis in different sections of population of Union Territory of Chandigarh

Infections with Toxoplasma gondii in humans are usually asymptomatic or in the form of mild febrile illness. Primary infection in pregnant women may result in congenital toxoplasmosis while infection in immunocompromised subjects like AIDS patients may cause potentially fatal toxoplasma encephalitis. In India, only a few studies in hospital based patients have shown prevalence of toxoplasmosis to be between 1.5 and 21%. No field study involving general population is available. The present study investigates the prevalence of toxoplasmosis in subjects from rural, urban and urban slum populations of Union Territory, Chandigarh. Serum samples from 500 subjects from each group were collected and antitoxoplasma IgM and IgG was detected by conventional micro ELISA technique using soluble Toxoplasma gondii tachyzoite antigen. Overall 5.4% subjects were positive for IgM while 4.66% showed IgG antitoxoplasma antibodies. Amongst the three groups, significantly higher number of subjects in slum area (7.8%) showed IgM antibodies as compared to urban and rural areas (4.2% each). There was no significant difference in IgG positivity between three study areas. Prevalence of T. gondii specific IgG antibodies was significantly higher amongst females of both slum (7.31%) and rural area (8.44%) as compared to the males (2.85% and 3.27% respectively) in the same areas (p<0.05) and also to females of the urban area (2.98%, p<0.05). Prevalence of IgM antibodies was significantly higher (p<0.05) in females in the slum area (10.5%) as compared to females in the urban area (2.55%). In both urban and slum areas, highest IgM seropositivity was observed in age group 6-12 years (10% and 13.3% respectively), while in the rural area the highest IgM seropositivity was seen in the age group > or = 5 years (17.7%). These data indicate that majority of children are exposed to toxoplasma before 12 years of age and particularly in rural areas higher number of subjects acquire Toxoplasma gondii infection early in childhood probably as a result of higher exposure due to farming, poor hygiene and handling of animals.     

Determination of IgG, IgM and IgA antibody responses in human toxoplasmosis by enzyme-linked immunosorbent assay (ELISA)

A 4-layer modification of ELISA for the determination of toxoplasma antibodies is described. In 103 Finnish blood donors 27 had antibodies against Toxoplasma gondii. One donor had IgM antibodies and IgA antibodies were found in 9. In patients with acute toxoplasmosis a vigorous IgG antibody response resulted in high antibody levels soon after infection, declining gradually to mean adult levels in approximately 2 yr. IgM antibodies appeared during the earliest phases of infection and disappeared as early as in 1 or 2 months in some cases and in most cases by the 6th month after infection. An IgA antibody response was also always seen. It was slower than the IgM response and could therefore be used to improve the laboratory diagnosis especially in cases where IgM antibodies had already disappeared and no further increase in IgG antibodies could be detected.     

小儿脑瘫、精神发育迟滞、癫痫与弓形虫感染关系的研究

本文同时采用3种血清学方法检测了210例不明原因的脑瘫、精神发育迟滞和癫痫患儿及100例正常小儿血清和部分患儿脑脊液弓形虫抗体。结果表明:脑瘫和精神发育迟滞弓形虫感染率分别为41.3％和38.6％,明显高于对照组(14％)(P<0.01),提示弓形虫感染是不明原因的脑瘫和精神发育迟滞的重要病因之一;癫痫组弓形虫感染率为18.3％,与对照组比较差别无显著性,似提示弓形虫感染可能与该组癫痫关系不大。在弓形虫抗体阳性患儿中,抗体效价多偏低,仅提示过去感染。患儿血中弓形虫抗体与其脑脊液中抗体之间有相关性。     

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;抗体滴度分折,ELISA一般高于IHA2～10倍。25份ELISA IgG抗体阳性血清,IFA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。     

Toxoplasma gondii spreading in an urban area evaluated by seroprevalence in free-living cats and dogs

Infection by the protozoan parasite, Toxoplasma gondii is widely prevalent in humans and animals throughout the world. Transmission takes place mainly by ingestion of raw or undercooked meat that contains parasite cysts or by ingestion of oocysts excreted in cat faeces, which can contaminate water and raw vegetables. The incidence of toxoplasmosis in urban areas can thus be also related to environmental contamination with oocysts. A direct measure of this environmental contamination by oocyst counting is unfeasible for technical reasons. An interesting alternative for measuring T. gondii urban spreading is the seroprevalence in free-living urban animals, used as sentinels, once they are exposed to similar risks of Toxoplasma infection-like humans. With this aim, we tested serum samples from stray cats and dogs for antibodies to T. gondii by indirect haemagglutination assay (IHA) and enzyme-linked immunosorbent assay (ELISA). Antibodies to T. gondii were found in 40% (40 of 100) of the cats, less than the 50.5% (101 of 200) found in dogs by ELISA (P < 0.05). Haemagglutination showed low resolution and concordance, precluding their use for diagnosis of T. gondii infection compared with ELISA. The prevalence of T. gondii was lower among stray cats probably due to their selective alimentary habits and lower water and food intake. Toxoplasma gondii seroprevalence in stray dogs and cats could be an indirect indicator of the parasite spreading in urban areas.